HomeMy WebLinkAbout02-1156PETITION FOR PROBATE and GRANT OF LETTERS
Esrare ~,. E ~7~irr~e cSLiu/fz
also knoirn as ~lzo ~j /y~or;~~ ~ f~f' 7-
- - Deceased.
Social Security No. c~ /~ o? ~- o ~
The petition of the undersigned respectfully represents that:
the
four petitioner(s), ~~ho isiare 18 years of age or older an the executtzr_~____
in the last will of the above decedent, dated named
and codicil(s) dated - ~Z .TGrlulny ,~9p_~__
(,rate relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in CG[nr ~-f~cnq~ _ County, Pennsylvania, with
~ last family or principal residence at ~fOZ ~~/e ~r~~e ~_~~~~
o _
(list street, number and muncipality)
Decyen~d7ent, then 74 years of age, died
at ~OZ /~fJ~~i ~r.vi l~lo~is.s.s.',t
~7~o z
Except as folla~es, decedent did not marry, was not ivorced an did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property ~ moo, oap..a
(If not domiciled in Pa.) Personal property in Pennsylvania $
(If not domiciled in Pa.) Personal property in County $
Value of real estate in Pennsylvania $
situated as follows: __d~a~,~~G,(,/~
WHEREFORE, petitioner(s) respectfully re uest(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters ~ ~~i~/t~ty
(testamentary; administration e.t.a.; administration d.b.n.c.t.a.)
theron.
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COMMONWEALTH OF PENNSYLVANIA 1
COUNTY OF C~~3~~ND
Register of Wills for th
County of _ ~~ in
Commonwealth of Pennsylvania
ss
"The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
Sworn to or affirmed and subscribed ~__ ~~`
c~ ~ Gam"
before me this __ 19th daY of ~ ~u~-,c ~,~
r,December „~ ~x 2002 f A
zr~ ----T ~~ _, i
Donna M. Otto, 1st Deputy
No. al ~Ua -115 ~
To:
r
~~ S tread iQoac/
,%~ /70/9
Q/. ~i~- ~ Z- 907.E
OATH OF PERSONAI. REPRESENTATIVE
eg
n
No. 21 ~~m „~ti
Estate of E. MARIE SHULTZ. aka ELIZABETH MARIE SHULTZ ,Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
DECII~IBER 20TH, I~ 2002in consideration of the petition on
AND NOW
the reverse side hereof, satisfactory proof having been PJ~u~rvel2tl'ne~2002
IT IS DECREED that the instrument(s) dated
described EereMARIEdS 1HCTL,TZ,p akat ELIZfABETII rMARIEa SHULTZ wi11 of
and Letters
are hereby granted to LARRY E. SHULTZ AND DORO`T'HY A. HILDEBRAND
FEES
50.00
Probate, Letters, Etc. ......... ~
Short Certificates( 4) ...... • . • . ~ ~ ~ - n(~
~f#$~c~~...1.?~Pages.... ~ 3.00
JCP 10.00
TOTAL $75.00
Filed Dec~nber .20th, , 2002 , .......... .
'~ ,~~.
Register of Wills ~~lC'
DONNA M. OTTO, t DEPUTY
ATTORNEY (Sup. Ct. LD. No.) ~FlS/.3
~ Cl usci' tea! /I'leC~~~r•~s6irl~~•4 I7o .5~
ADDRESS
~~7- 7~ to -d z ~ /
PHONE
MAILED LETTERS TO ATTORNEY ON DEC~'MBER 20th.
LAST WILL AND TESTAMENT OF E. MARIE SHULTZ
I, E. MARIE SHULTZ, of the Borough of Mechanicsburg, Cumberland County,
Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish anal
declare this my Last Will and Testament, hereby revoking and making void any and all prior Wills
by me at any time heretofore made.
1.
I direct the payment of all my just debts and funeral expenses as soon after my decease as the
same can conveniently be done.
la.
I give and bequeath the sum of one thousand ($1,000.00) dollars to each of my grandchildren
listed in this paragraph as follows, to wit:
A.) Erin Seltzer;
B.) Ryan Hildebrand; and
C.) John Coons.
In the event any of them predecease me, his or her gift, as the case may be, shall lapse and
shall become part of the residue of my estate. Any inheritance taxes due upon the above gifts shall
be paid from the residue of my estate. ~ ~ ~~ ~'LO -~ Q '~2~~ ~ ~ '
® ~. ~~ ~~
I am possessed of a lot of ground in Huntingdon County, Pennsylvania, situate between
Robertsdale and Huntingdon. Should my son, LARRY E. SHULTZ, survive me, then I grant him the
option to purchase this lot from my estate at a price of Five Thousand ($5,000.00) Dollars. I
understand that the fair market value of the lot may be in excess of this figure and that its fair
market value will be the amount used to assess inheritance taxes against my estate. My said son shall
have ninety (90) days to make up his mind and complete the purchase of the lot from my estate. In
the event m_y said son predeceases me or decides not to exercise this option, the option shall lapse
and the prapcrty free- and clear of such option shall be considered part of the residue of m~-~ estate.
3.
All the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and
wheresoever situate, I give, devise and bequeath in equal shares to my beloved children, per .stirpes:
LARRY E. SHULTZ, LONNIE E. SHULTZ, DOROTHY A. HILDEBRAND, and LADENE M.
MYERS.
~~~ ~~~
4.
I nominate, constitute and appoint my son, LARRY E. SHULTZ, and my daughter,
DOROTHY A. HILDEBRAND, to be the Co-Executors of this, my Last Will and Testament. I
further direct that they shall not be required to file bond or other security in the Office of the
Register of Wills for the purpose of administering my Estate.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this day of
A.D. 2002.
~~ _ (SEAL)
E. MARIE SHULTZ
Signed, sealed, published and declared by the above-named E. MARIE SHULTZ, as and for
her Last Will and Testament, in the presence of us, who at her request and in her presence, and in
the presence of each other, have hereunto subscribed our names as witnesses.
°~~
2
21-2002-1156
REGISTER OF WILLS OF COUNTY
OATH OF SUBSCRIBING WITNESS
codicil
(each) a subscribing witness to the will presented herewith, (each) being duly qualified according to
law, depose(s) and say(s) that present and saw
the testat ,sign the same and that signed as a witness at the
request of testat in 1~_ presence and (in the presence of each other) (in the presence of the
other subscribing witness(es)).
Sworn to or affirmed and subscribed before
me this day of (Name)
19
Register
(Address)
(Name)
(Address)
21-2002-1156
REGISTER OF WILLS OF Cu m r~~u.~wy COUNTY
OATH OF NON-SUBSCRIBING WITNESS
L.¢~t'i~Y ~: S~yu~ i z
-Eeae~}) a subscriber hereto,-Eeac-li) being duly qualified according to law, depose(s) and say(s) that
x'12 i S familiar with the signature of ~- /llar~e ,f~iu /fz
ee~iecl-
testat rix of ) the will presented herewith and
codicil
that hE believes the signature on the will is in the handwriting of
F /1J,¢rP/F .SHut TZ
to the best of LJiS knowledge and belief.
S
Sworn to or affirmed and subscribed before C~ - `'
me this 19th day of L,lrrry E. tz (Name
DecemY~er )
~OZ ~ 2 AAo/t ,Or. /e~ /Ylec~iaaics 6u~y, /Ji~f ~705,~
a ~ ~ (Address)
Register
(Name)
(Address)
21-2002-1156
REGISTER OF WILLS OF C urh /~Lf~~iLD COUNTY
OATH OF SUBSCRIBING WITNESS
L'yr~,~LE,f ~: S/S~/~Zl~s
r---~^7"dic^iT-
-(€ael~ a subscribing witness to the will presented herewith,-(gael~ being duly qualified according to
law, depose(s) and say(s) that _ H~ Lr/i~S present and saw
the testatrix ,sign the same and that ~`~'~' signed as a witness at the
request of testat rte- in 1~.~ presence and r) (•
other subscribing witnessEesJ). /~/~~ ~ ~~ ~' ~j~
Sworn to or affirmed and subscribed before (.ti%CG'~GG~ C ; i ~~i~2~~~GC/,f
me this _ 1 h _ day of Charles E. Sh; e%ls ~!
December 6 C/a~rs~i' ~Pa! (ame)
2ooZ _ /~echa~ ~c s 6Lrs~~ oo•¢ /7o,y~-
(Address)
Donna M.Otto, 1st Deputy Regi e>~
(Name)
(Address)
REGISTER OF WILLS OF COUNTY
OATH OF NON-SUBSCRIBING WITNESS
(each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that
familiar with the signature of
codicil
testat of (one of the subscribing witnesses to) the will presented herewith and
that
codicil
believes the signature on the will is in the handwriting of
to the best of Knowledge and belief.
Sworn to or affirmed and subscribed before
me this day of
19
Register
!Name)
(Address)
(Name)
(Address)
CERTIFICATION OF NOTICE UNDER RULE 5 6(a)
Name of Decedent: E. Marie Shultz a/k/a Elizabeth Marie Shultz
Date of Death: December 17, 2002
Will No. Admin. No. ~)~
TO THE REGISTER:
I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court
Rules was served on or mailed to the following beneficiaries of the above-captioned estate on
January 3, 2003:
Name Address
Larry E. Shultz 802 Apple Drive, Mechanicsburg, PA 17055
Dorothy A. Hildebrand 12 Stonehead Road, Dillsburg, PA 17019
Lonnie Shultz 1101 N. W. 30th Court, Witton Manors, FL 33311
La-Dene Myers 6 Earl Street, Boiling Springs, PA 17007
Erin Seltzer 25 Greenbriar Lane, Dillsburg, PA 17019
Ryan Hildebrand 12 Stonehead Road, Dillsburg, PA 17019
John Coons
c/o Dorothy A. Hildebrand 12 Stonehead Road, Dillsburg, PA 17019
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date: January 3, 2003
6 Clouser Road
Mechanicsburg, PA 17055
Telephone: (717) 766-0209
Counsel for Personal Representative
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COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
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DECEDENT'S NAME (LAST, fiRST, AND MIDDLE INITIAL)
SHULTZ., c:LJZAI!3E7f../ 1Y1.
DATE Of DEATH (MM-DD-YEAR) DATE Of BIRTH (MM-DD-YEAR)
1:l-/7- 2,!Jog O:z- II -/'13z
(If APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
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OFFICIAL USE ONLY
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~ 1. Original Return
o 4. Lirnited Estate
~ 6, Decedent Died Testate \.I>.tlachcopy olWm)
o 9. Litigation Proceeds Received
o 2. Supplemental Return
o 4a. Future Interest Compromise (date of death after 12-12-62)
o 7. Decedent Maintained a Uving Trust (Attach copy of Trust)
o 10. Spousal Poverty Credit (dale o/death betwee~ 12-'11.91 al\d 1-1-95}
FILE NUMBER
.2L-J2~
CQUNTYCQOE YEAR
.E. -.-!. -1- 5t;,
NUMBER -
SOCIAL SECURITY NUMBER
:<Of! -..:}If.
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THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
o 3. Remainder Return (date of death prior to 12-13-82)
o 5, Federal Estate Tax Return Required
D 8, Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (Mach Sch 0)
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NAME elf If II!.LES Ii:
FIRM NAME (If Applicable)
COMPLETE MAILING ADDRESS
{; CLOUSl:/p 1f?0~D
m€C#AAI/csBlIRG-~,I7,1 /70ss-
SH/€/.DS 1JI:
OFFICIAL USE ONLY
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(B)
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TELEPHONE NUMBER
7/7- 71#" -620'1
(11)
(12)
(13)
, 5'2, ".0,'2.
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1, Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
(1)
(2)
(3)
(4)
(5)
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(14)
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3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Nates Receivable (Schedule D)
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5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6, Jointly Owned Property (Schedule f)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
1(}, Debts of Decedent, Mortgage Uabllitles, & liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election 10 lax has not been
made (Schedule J)
(6)
(7)
(9)
(10)
,
. ~2...t lfol.,SfR
1":19 3S<I.:lf,
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14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SlOE FOR APPLICABLE RATES
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15. Amount of Line 14 taxable at the spousal tax 0
rale. or transfers under Sec. 9116 (a)(1.2) x .00 , (15)
, 3/, 9'1S'. 1'1
16. Amount of line 14 taxable at tineal rate x .O~!j'_ (16)
17. Amount of line 141axable at sibling rate {} x .12 (17)
18. Amount of line 141axable at collateral rate IJ x .15 (18)
19. Tax Due (19)
CHECK HERE !F YOU ARE REQUESTING A REfUND JF ~N OVERPAYMENT
Decedent's Complete Address:
STREET ADDRESS fo,2 APPlE '"Die IVE
~
CITY fYIt:CHI/-NICsa~JI/~ I STATE ,011 I ZIP 1'70.s-~
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credils/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
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TotaiCredits(A+B+C) (2)'
3. InteresVPenalty if applicable
D. interest
E. Penalty
1/
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TotallnteresVPenalty ( 0 + E ) (3)
4. If Line 2 is greatarthan Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
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5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This Is the TAX DUE. (5)
A. Enter the interest on the tax due.
(SA)
B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
1'1. 'f37.~.-
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f I. 'i 3 7.S'4
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1.
Did decedent make a transfer and: YO.
a. retain the use or income of the property transferred;.......................................................................................... .J
b. retain the right to designate who shall use the property transferred or its income; ............................................ 0
c. retain a reversionary interest; or.......................................................................................................................... 0
d. receive the promise for life of either payments, benefits or care? ...................................................................... 0
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ........................... ...................."...................................................."'''m. ~
3. Did decedent own an "in trust fo~ or payabie upon death bank account or security at his or her death? .............. 0
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a benefidary designation? ........................................................................................................................ 0
No
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129.
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN,
Under penalties of pe~ury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowiedge and belief, it is true, correct
and compfele.
Declaration of preparer other than the personal representative is based on all information of which preparer has any kl'lOWledge.
SIGNATURE OF PERSON RESPONSIB E FOR FiliNG RETURN
x
DATE
/V~ 03
'70,Q
For dates of death on or after Juiy 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 P.S. 99116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 99116 (a) (1.1) (ii)].
The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are 8tm applicable even if
the surviving spouse is the only beneficiary.
For dates of death on or after Juiy 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent,
or a stepparent of the child is 0% [72 P.S. 99116(a)(1.2)].
The tax rate imposed on the net vaiue of transfers to or for Ihe use of the decedent's lineal benefidaries is 4.5%, except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 99116(a)(1.3)]. A sibling is defined, under Section 9102, as an
individual who has at least one parent in common with the decedent, whether by blood or adoption.
~,~""cg7l.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
5Hu.L -rZ, E: /J1/1J1eIE
FILE NUMBER
.2 1 - 02 - II Sfo
All property joinUy.owned with right olsul'lNorship must be disclosed on Schedule f.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
<f/~, 109.5"0
1,
AIJfEIfICIPN EXI"RES.:S __ FI/lI~IV(!I/IL .II.l>f/lsc/f'S/ life!.
(SEE {/ALulI7itJN LE T'Tsr P/tPJlIDE1> 13y t<J/!)'//E LoGUE
/l77}fellE1) h'.sE'E70)
TOTAL (Also enter on line 2. Recapitulation) $ J:2, /o'l.. SD
(If more space is needed, insert additional sheets of the same size)
American Express
Financial Advisors Inc.
IDS li1e Insurance Company
Suite 200
B I '11 find th al fM' Shul ' D b 1 0 342 North Fro"t Street
e ow you WI e V ues 0 ane tz s accounts on ecem er 7, 20 2. Wormlevsburg. PA 17043
Bus. 717.9750202
Bus 800.975.6680
Fa, 717975.2700
January 13, 2003
Charles E Shields, III
6 Clouser Road
Mechanicsburg, Pa 17055
Dear Mr. Shields:
Account number
Select Fund
010527720659002
Bond Fund IRA
01122772065 0 002
Blue Chip Advantage IRA
013127720657002
Select Fund IRA
02052772065 8 002
Growth Fund IRA
021927720652002
7D7iH.
.'_SAIOON
EllP.F.II!SS
Financial
Advisors
Advanced Advisor Grou
Wayne A. Logue, CFP
Senior Finandal Advisor
Certified Financial Planner
Value 12/17/2002
Shares
$ 669.64 77.606
$3803.12 796.379
$2072.40 335.883
$3605.38 418.012
$1958.96 100.666
~ 12, 10 'i. 5{)
If there is anything further that I can do, please call me at 717-975-0202.
Sincerely,
vJ~~ ~
]
Wayne Logue
American Express Financial Advisors Inc
342 North Front Street Suite 200
Wormleysburg, Pa 17043
717-975-0202
717-975-2700 Fax
IIlSUranC8al1danntlltmsareissuen
!JY IDS life Insurance Companv,
an Amellcan Express company.
snooD
1111111111111111111.
Statement of Financial Accounts
January 1, 2002 - January 7, 2003
Group Ijum~'r " ~"H!l65 5 QQt
Check Your A~\Jllt.
Aallomll14 T..op_ s.nIIQtO
800-662.7919 ' '"
Online
ho",e2.ameri~~~.~""<;ll!'!;,
Summary of Accounts by Product Symbol Account number Vllu. one year ago Value last statamenl Current value
Mlltllal Funds $28,602.98 $11,559.10 $12,215.25/
AXP SELECTIVE FUND CLASS A IHSEX 0010 5277 2065 9 002 $664,05 $667.61 $874.71 ./'
AXP BOND FUND CLASS S, IRA .HINX 0011 2277 2065 0 002 $9,630,67 $3,751.56 $3,843.60
AXP BLUE CHIP ADVANTAGE FUND CLASS S, IRA (DBeX 0013 1277 2065 7 002 $4,319.53 $1,810.41 $2,118.0Il ,/'
AXP SELECTIVE FUND CLASS B, IRA (SEBX 0020 5277 2065 8 002 $9,646.25 $3,600.06 $3,831.0Il
AXP GROWfH FUND CLASS B, IRA (ORBX 0021 9277 2065 2 002 $4,342.46 $1,729.44 $1,949.90
Insurance $3,182.85 $3,219.08 $3,272.03
WHOLE LIFE 0900 0129 5066 2 004 $3,162.65 $3,219.06 $3,272.03
Additional Products Not allDllcable Not alllllicable $0.00
UNSECURED CREDIT LINE 0030 0004 1263 0 039 Not applicable N at applicable Se. service page
IRA/CESA Plan Contributions
plan MARIE E SHULTZ
Owner IRA Plan
Plan Made for 2003 $0.00
Contributions Rollover 2003 $0.00
Summary of Accounts by Ownership Symbol Account number Value one yaar ago Value last statement Current value
MARIE E SHULTZ $3,846.90 $3,886.69 $3,946.74
AXP SELECTIVE FUND CLASS A INSEX 0010 5277 2065 9 002 $664.05 $667.61 $674.71
WHOLE LIFE 0900 0129 5066 2 004 $3,182.65 $3,219.08 $3,272.03
UNSECURED CREDIT LINE 0030 0004 1263 0 039 Hot applicable Not applicable S.. service page
MARIE e SHULTZ IRA $27,938.93 $10,891.49 $11.540.54
AXP BOND FUND CLASS B ININX 0011 2277 2065 0 002 $9,630.67 $3,751.56 $3,543.60
AXP BLUE CHIP ADVANTAGE FUND CLASS B 'DBeX 00131277 2065 7 002 $4,319.53 $1,610.41 $2,118.0Il
AXP SELECTIVE FUND CLASS B ISEBX 0020 5277 2065 6 002 $9,646.25 $3,600.06 $3,831.0Il
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Statement of Financial Accounts
J~nuary 1, 2002. January 7, 2003
Mutual Funds
559000
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cp.qu, 1#1Ill!lIltr- ~l? 2~ ~!J!?l.s<
AXP Selective Fund
4CJ:Ount owner(s)
MARIE E SHULTZ
Date account opened 07/08/1986
YOIl. lIccount performance
Values shown represent past history for this account and include the effect of any
sales ctlarges paid. Investment value may f1u<:tuate Past performan<:e does not
guarantee future rl!Sults. If you have questions regarding this performan<:e
information, please <:onsult your financial advisor or your service offi<:e
~CC!l!lnt !lctivity
Cle.. of Number Price
Dale Acllvltv share. of shares X Der share =
01/25/2002 R.inv.sl.d divid.nd A 0.285 $8.880
'II ~0.0342 p.r shar.
02/26/2002 R.inv.sl.d divid.nd A 0.258 $8.850
at 50.0305 p.r shar.
03/26/2002 Rllinv.sl.d divid.nd A 0.197 $8.750
'II $0.0238 p.r shar.
04/26/2002 R.inv.sl.d divid.nd A 0.225 $8.770
'II 50.0269 p.r shar.
OS/24/2002 R.inv.sl.d divid.nd A 0.284 $8.710
'II $0.0326 p.r shar.
06/26/2002 Reinv.sl.d divid.nd A 0.293 $8.640
'II 50.0336 p.r shar.
07/26/2002 R.inv.sl.d divid.nd A 0.282 $8.560
'1150.0316 p.r shar.
Dollar ~
amount
$2.53
$2.28
$1.72
$1.97
$2.47
$2.53
$2.41
Continued
Account number 00105277 2065 9 002
Current account value
on 01/07/2003
Class A shares owned
Current price per share
Accrued dividends
Estimated average cost per share"
Cash invested to date"
Reinvested dividends
Cash dividends
Accrued dividends
Market gain (loss)"
Cash withdrawn""
Account Value
$674.71
78.217
$8.610
$1.26
$9.16
$12,090.00
$7,896.80
$0.00
$1.26
$301.75
($19,615.10)
$674.71
This number is an estimate and should not be used in your tax
calculations. Consult a professional tax advisor when calculating taxes
Includes realized gain (loss), unrealized market appreciation
(depreciation), and sales <:harges
Includes redemptions, exchanges, cash dividends. taxes withheld,
custodial fMS and conversions to class A
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Statement of Financial Accounts
January 1, 2002 - January 7, 2003
Group Humiltr-,- ~n ~Qll5 U9L-
AXP Bond Fund. IRA
~C!:llllnt pwner(s)
AMERICAN eXPRESS TRUST COMPANY
C/O MARIE E SHULTZ
AS CUSTD FOR THE MARIE E SHULTZ IRA
Date account opened 11/13/2000
Y04r account performance
Values shown represent pasl history for this account and include the effect of any
sales charges paid. Investment value may fluctuate Pas1 performance does not
guaranlee futurt results, If you have questions regarding this performance
information, please consult your financial advisor or your service office
Accollnt activity
Class 0' Number Price Dollar
Date Actlvltv shares of shara. X Der .hare = amount
01/15/2002 Scheduled investment exchange B (20.619) $4.850 ($100.00)
to Growth B 0021 9277 2065 2 002
01125/2002 Reinvested dividend B 7.131 $4.810 $34.30
at $0.0172 per share
02/15/2002 Scheduled investment exchange B (20.790) $4.810 ($100.00)
to Growth B 0021 9277 2065 2 002
02/26/2002 Reinvested dividend B 7.231 $4.800 $34.71
at $0.0175 per share
03/15/2002 Scheduled investment exchange B (21.053) $4.750 ($100.00)
to Growth B 0021 9277 2065 2 002
03/26/2002 Reinvested dividend B 7.381 $4.750 $35.06
at $0.0179 per share
04/15/2002 Scheduled investment exchange B (20.964) $4.770 ($100.00)
to Growth B 0021 9277 2065 2 002
04/26/2002 Reinvested dividend B 7.421 $4.780 $35.47
at $0.0182 per share
Continued
559000
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Check Vour A~Cowda .'.
Automated T".~ hAI..
80ll-862-7919
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Account number 0011 2277 2065 0 002
Current account value
on 01/07/2003
Class B shares owned
Current price per share
Accrued dividends
Estimated average cost per share'
Cash invested to date'
Reinvested dividends
Cash dividends
Accrued dividends
Market gain (loss)"
Cash withdrawn'"
Account Value
$3,843.50
799.310
$4.600
$6.61
$4.66
$10,000.00
$692.37
$0.00
$6.61
$244.32
($7 ,300.00)
$3,643.50
This number is an estimate and should not be used in your tax
calcula1ions. Consult a professional tax advisor when calcula1ing taxes
Includes realized gain (loss), unrealized market appreciation
(depreciation), and sales charges
Includes redemptions, exchanges, cash dividends, taxes withheld,
custodial fees and conversions to class A
If you sell Class B shares, you may pay a sales charge, For more information
on charges and other fees, please refer to your prospectus.
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II~ UmllIllll
Statement of Financial Accounts
Janu;uy 1, 2002 . January 7, 2003
:~. .~.' ~..,. ";-:,: :,:.>:;Ii!:-;;i !)'';fl> ;,,', /. ;',:;'-
Check v"ur=unfil'~' '
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AXP Blue ChiD AdvantaGe Fund. IRA
AC!=llllnt IlWnt,r(s) Date account opened 11/13/2000
AMERICAN EXPRESS TRUST COMPANY
C/O MARIE E SHULTZ
AS CUSTD FOR THE MARIE E SHULTZ IRA
Your a!:COunt performance
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'~I"j~k1P~~;~~lil:
Values shown represent pasl history for this account and include the effect of any
s<!l!l$ ch~r~es paid, Investment value may fluctuate Past performance does not
guar~nt,e future r,sults. It you have questions regarding this performance
informalion, please consult your financial advisor or your service office
Accou.n* ilc~ViW
Cia.. 01 Number Prlca DolI.r
Data Actlvltv ahare. of share. X oer .h.re = amount
01/15/2002 Scheduled investment exchange B 12.755 $7.840 $100.00
from Selective B 0020 5277 2065 8 002
02/15/2002 Scheduled investment exchange B 13.175 $7.590 $100.00
from Selective B 0020 5277 2065 8 002
03/15/2002 SCheduled investment exchange B 12.594 $7.940 $100.00
from Selective B 0020 5277 2065 8 002
04115/2002 Scheduled investment exchange B 13.245 $7.550 $100.00
from Seleclive B 0020 5277 2065 8 002
05115/2002 Scl)eduled investment exchange B 13.316 $7.510 $100.00
frpm Sllleclive B 0020 5277 2065 8 002
05/30/2002 Redemption B (273.224) $7.320 ($2,000.00)
Account number 0013 1277 2065 7 002
Current account value
on 01/07/2003
Class B shares owned
Current price per share
Estimated average cost per share"
Cash invested to date"
Reinvested dividends
Cash dividends
Accrued dividends
Market gain (loss)"
Cash withdrawn""
Account Value
$2,116.06
335.883
$6.300
$9.81
$5,566.67
$41 0.46
$0.00
$0.00
1$1,861.071
$2,000.00
~
lhis number is an estimate and should not be used in your tax
calculations. Consult a professional lax advisor when calculating taxes.
Includes realized gain II0SS}, unreahncl market appreciation
(depreciation), and sales charges
Includes reampticms, 8)(changes, cash di..ndends, taxes withheld,
custcxlial fe.s and conversions to class A
If you selt Class B shares, you may pay a sales charge. For more information
on charges and other f..s, please refer to your prospectus.
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Statement of Financial Accounts
JanulIry 1, 2002 - JlInulIry 7, 2003
~",up "limbs' OQ77 ?0Il5 5 OQl "
( !=(antlmuul)
AX!' Selective Fund. IRA
Accolln* activity
Class of Number Price Dollar
Date Activity shares of shares X Der share = amount
0511512002 Scheduled investment exchange B (11.547) $8.660 ($100.00)
to Blue Chip Advant B 0013 1277 20657002
OS/24/2002 Reinvested dividend B 3.304 $8.710 $28.78
at $0.0276 per share
0513012002 Redemption B (629.291 ) $8.740 ($5,500.00)
0612612002 Reinvested dividend B 1.698 $8.640 $14.67
at $0.0276 per share
0712612002 Reinvested dividend B 1.265 $8.560 $10.83
at $0.0262 per share
081261a002 Reinvested dividend B 1.247 $8.640 $10.77
'., at $0.0258 per share
0910912002 Custodial fee B (2.199) $8.640 ($19.00)
0912612002 Reinvested dividend B 1.416 $8.660 $12.26
at $0.0295 per share
10/2512002 Reinvested dividend B 1.459 $8.500 $12.40
at $0.0298 per share
1112512002 Reinvested dividend B 1.382 $8.560 $11.83
at $0.0286 per share
1212012002 Rl>invested dividend with capital gains B 3.095 $8.610 $26.65
Long-term capital gains at $0.0258 per share
Short-term capital gains at $0.0095 per share
Dividend income at $0.0284 per share
!iS9000
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Check V~~~~~~~; . .
Automated Telephone 'e....oe
500-562-7919
=~~.ame"l;l!__.corm!lltlC.
Account number 0020 5277 2065 8 002
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Insurance
Statement of Financial Accounts
JliInuliIry 1, 2002 . January 7, 2003
!iS9000
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Check Vour ~t. '
Automal.~ TII"" a.Alee
800-862-7919
0nIi~ '
hOj1l ,11TIfI:,~~"""P9I111~I;C-_"
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$10,000.00
$9,869.18
ACCOUIllllctivity
IP@ l-If~
Whol~ Life Inaurance
POlicy own\!!r(s)
MARIE E SHULTZ
Insured
MRS MARIE E SHULTZ
05/15/1983
Death benefit
Death benefit net of loan
Actlvltv
Automatic premium 'oan
Premium
Premium
Doll.,
amount
$130.42
$126.55
$126.55
Pollcv Number
0900 0129 5086 2 004
POIIC~ Date
Date
11/15/2001
05/14/2002
11/15/2002
Current polley value
on 01107/2003
Value if surrendered
$3,272.03
$3,272.03
Generallnfonnation
Premium $126.55 semi-annually
Next premium due date 05/15/2003
Loan Information
Loan balance this statement $130.82
Rate charged on loan 7.40%
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Statement Mailed to
MRS MARI~ ~ SHULTZ
802 APPL~ DR
M~CHANICSBURG PA 17055-3405
:::::,:::',:::::,:-,:.,:::,:i:"',:',':<:;::;'::,.),;,,:.:',:-,':",;0':::,)::::<:::>:;::'::::::,:::::::'::'::::;::::::::::.':::'.::::::::::::::::::,::::'
.........."...-.._,.,.........,............,................,.....,..,....,.,...
.,._,.......,_.,........,... ..,.,....,....,..,..,.,....,..,.,',...,.."...
..,..',.,'_.....,....'...'.',','.'...:..:....'.-.'..,::.'..'.'.'.',','.,-,:-',-,'-'-,,:,.-.,-,'-',','.',-.' ','-','. ',',','.',','-',-,-.,,"
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S~we, Invest, Spend,
Borrow: All in ONE.
Introducing the American Express ONE
Financial Account, an investment account
with the added benefits of everyday
banking, including free I.Inlimited
check-writing, an AnA Card, online bill pay
and ml.lCh mOre. And, with total account
Cfssets of '25,000 or more, you can get a
complimentary American Express Gold
Card. ONE, combined with personalized
advice available from your financial
;:idvisor, CC1n help you move your money
forward as never Defore. Speak to your
advisor for more information. (Financial
advisory service is offered separately,
priced according to your needS.)
00100027720050000001 01107/2003
!iS9000
IIII I ~1I11111
Statement of Financial Accounts
Janua~.1i'2OO1l", Jaallll~..cIG03 /. .~.~. ..,'. ",,,c+..,'q:,. .",......... ,;. ".
Group Number 0277 2065 5 001
Client Number 10237101 0001
MRS MARIE E SHULTZ
Check Your Accounts
Automated Telephone Service
800-862-7919
Online
home2.americanexpress.com/cacc
DIrect your .ervlce and Investment questions to
WAYNE LOGUE CFP
342 North Front St Suite 200
Wormleysburg PA 17043-1112
717-975-0202 Ext. 2
717-975-2700 FAX
800-975-6680 Toll free
American Express Portfolio Summary
Where your alsets Percent of
are Inve.ted all current value Value
by product products ProducllYPo one year ago last stat.ment Current valu'
D 0% Money Market Funds and Cash Not applicable Not applicable NOC:;;ab1e
D 79% Mutual Funds $28,602.98 $11,559.10 ""'.
$12,21!--25/
~ 0% Securities Not applicable Not applicable Not applicable
S 0% Annuities Not applicable Not applicable Not applicable
iillJ 0% Certificates Not applicable Not applicable Not applicable
. 210/4 (ns.urance $3,182.85 $3,219.08 $3,272.03
a 0% Limited Partnerships and R~ITs Not applicable Not applicable Not applicable
~ 0% Additional Products Not applicable Not applicable $0.00
100% Total value 01 an accounts $31,785.83 $14,778.18 $15,487.28
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UOI~IIWJOIUI 8JOW paau no}. ^llM JO UJ8:)UO:>
II! Sl aJ8111 8M118q noA J.4M ue:> neA se AIJeel:) SII Ulllldx3
BJnSUn 8JII noA 4::1!1.IM ,noqe J8jSUeJl JO JOJJa 'anSS! all!
Jaqwnu dnoJJ5 JO )uno:):)1l" pUll! SWIIIU Jno).
:UO!1I11WJOjU! 15Ul.MOnOj a4~ ap!^oJd ilse8ld 'sn 8u":)l:\uoo ue~
'8AOer. SSlUpP. .IU Ie sn 1:t.,UO:t ..../d ISJuno:t~. ,moA au,jJ.Ji6e.l
SIU!.,dwo:t ,10 .U.J8:tUO:l .1.1110 u.lI noA II 'fU.Uljf.. -Iii tlltAl
.8.1e. noA I.IU pu.~pun 111M ..... 1!A.p 09 U!IU,.i in AJlJolJ
~u op nDA 1/ 'UO!,.UJ.JOJu/ ~u"sJw .JO .JO.J.J8 U. Im__ iU'W8ti,ilSIII:1 .'If nolf fun .M.J8U. Uep 0' u.1I1 J.J~I 011 rioA
WO.ll Je811 ,Inw 'M '8/er/SIOd sa uoos ri In .JfJM ,)0 .uolld.,ilJ
IJUeW8'.'. 81U uo A"^fJ:le .l8lnO.lO lalluitJI 'uolt:t"uiJI
. ,noqe UO!J.IJI.lO~UI 8.1OW "'8U noA 11 .JO 11Io"iLii.ioju!
,uno:t:t. 8Ur-S!1U Sf '8UO../M Sf w-umJ.n .moA ,u,ill noA
JI 'AunI8J.:t ,uew.._,. 'IlIl JO saG_d ".,.p -ii' M,,/ile.. .siiijd
GLGL-Z;99'009
"l.,gS NW'4 sHode.uun,
J81U8:) le!:)Ullu!::I dX"V' oo~Ol
UOnez!uIIoJO !SU!Je8l;) pue a:>I^-l8S IU8!!:)
s.tOSII\P'It IItI:lUIIU!::I SSa.Jd)(3 UII!:)!J8W'o'
O} S8plnbUll:)8.uQ
J.euow
JnoJ. lSMUI noJ. 8JoJaq ^lInjaJII!:) 1! pe8J 8se81d "snpedsoJd
II! JOJ sn l::>IIIUO:) 'S8SUad>aI pUll! seel pa,~:lOSSII &I.III)O/:)u,
'8::11Al8S JO J:lnpoJd ^ue uo UO!JIIWJOIUI 8~8fdwo:) 8JQW JO;;f
uoneWJOjUl 8~!t\J.S tuno:J:JY
R.v,~".,,:".
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESID NT DECEDENT
ESTATE OF
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
SHUL 12, e. /Jute/€.
~J-O:l-//S6
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointty-owned with the right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
~.
DESCRIPTION
I,IUM of PERSoll/HLTY 7D.8l: KE;:JT ",,/7H/N
FA/JUCY /9P/R#-ISED "BY C.HUCK B/?/cJ:€lf', /fUC7"1MJEa!?
(SEt: "'''~A''/9/.s.4C. .4 -rr"'f'(!'#€ZJ)
,f-eCPI//y73 Atr /I1E/)1,8EJ'fS 157 F6Z>~ ~n- UN/I)"':
,If. t€IFGtlt./hf' Sh/'/l/6,5 ..4ec'T. 476> R 7" - 4>0
15. A-cut 11Vr. t>/f/~.
e. (!.IIE'CK/III~ /feeT. ~76 J' 7-/1
J). A-CCA!. lAir. 0//1 C.
12'. jAli"ESTmEN7 S'fW/l/Gs /'fecT. ~7b37- oS
F. /'fee/('. 1/111: tllII L:.
3. S/rt.~ t9F /nt?7P.e t/e-LV/Ct.e
'f.
5.
)
1ft: FI/IV /) C,(!ED/T R7?/€' I/YS~,e. - /oIPAt/Fpt</41fli'S
,
Br?/CKERs AUC.-rtPN SA(.I;
(SEE S7A7EIHEN7" ~I)AI 8Itlcjq',f't 1f7T~OHE"b)
(fIlSI{ IN H/AUE- r
teE'~uAJD C1f!eDrr €R.IE XIVSut? - I:.AR INSuR.
VALUEATOATE
OF DEATH
~
II Y'S".O"O
~
S; ,,<;Z. 2 <{
,. 'f. 1./
~
7"'~. :?'1
_ zs-
a"
f1, 'I:l3./Z
"/3.b7
'!
7, '100.00
~/{).tJfJ
,..~ 'lIS. ()O
~
7t:>.t>1)
Jil" I D. 00
~
.5.30. {)O
(
7.
!.
IfSSoIlTG"f) /7"t;ms t>P cl/iWI:t..JeY
(SElf AfJ/t(A/SI/-{.. of J'}1W /lf4l/!-r d"U/Et.A:.Y S7P)!E A-7T4tN6".P)
TOTAL (Also enter on line 5, Recapitulation) $ 4 z. a 17.13
(If more space is needed, insert additional sheets of the same size)
APPRA(ISAL
Personal Property of 11 /fR./ E H. S' H Ij t- T "L. 1% TATE
Appraised by Chuck E. Bricker AU094-L
ITEM VALUE
iJ.t) J
SD,Cb
g6~ ArPa DR, }1 &11.8.3 PAt
Date {).. - :.z.s - d .3
ITEM VALUE
,vo
ow
/I! Lid
SO,a)
d. a 0
'/D Do
,j{) d~
O"""'ViJo
lSO,do
-; 66
ih
go, Ii
..2..6,1 d
fJ .2iJiJ 6,)
'-""
!:-)
C)
,'-, _ ,_, ,.-, C1 C) CJ
, c,:::- : 1- -~, C', ,......,
;:'1 r:: I c::' I::) ,_, ,:J :- (, '::I I
('"
-. u
"
'../ ,____" (:::l ,_:~) Cl r) C,) , , ,~~, c' '.::J l~ '. '..J
'::::', ,-;. ("-\ ,_ ,"', <',_ ,_' \J~, _ -.:- _ 1.0. ~.r\ CS\ C'-- t"'S
..~) ':=:: ,~::',
,'~-', "'~; ,~
.",
(',1
i
t
c.r)
co
MemberslSI
FEDERAL CREDIT UNION
RFr.l1l AR !':AVINC::;!': Ar.r.OIlNT'
Account Number/Suffix
Date Account Opened
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest to Date of Death
Name of Joint Owner
CHFCKINC::; ACCOIINT'
Account Number/Suffix
Date Account Opened
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest to Date of Death
Name of Joint Owner
INVF!':TMFNT !':AVINC::;!': ACCOIINT'
Account Number/Suffix
Date Account Opened
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest to Date of Death
Name of Joint Owner
VI~4 ~~l=nIT ~ARn A~~nIINT. -.------.----
Account Number
Date Account Opened
Balance at Date of Death
Name of Joint Cardholder
lOAN ACCOIINT'
Account Number/Suffix
Date of Disbursement
Principal Balance at Date of Death
Loan Description
Name of Co-Maker
Collateral Securing Loan
Estate of: MARIE E. SHUTLZ
Date of Death: December 17, 2002
Social Security Number: 211-24-9686
INSURANCE DEPARTMENT
5000 Louise Drive
P. O. Box 40
Mechanicsbur9, PA 17055
1-800-283-2328 or (717) 697-1161
47687 -00
03/14/1985
$5,692.24
$4.61
$5,696.85
None
47687 -11
03/14/1985
$763.24
$.25
$763.49
None
47687 -05
08/12/2002
$17,423.12
$13.67
$17,436.79
None
4121449998476878
03/20/1996
$2,010.47
None
47687 -01
02/14/2002
$646.16
Unsecured
None
Contractual Pledge of
Shares
',-",_'" ';'1
-+ ~,~
Ii /1 j'
47687 -02
02/26/2002
$1,238.03
Unsecured
None
Contractual Pledge of
Shares
M M
DIT UNION
Denise A. Anders
Insurance Products Supervisor
February 7, 2003
j"'C1t!..~H"Ii.a.~
~......._..'.... --
~R~"g, Amsrica's MosrConllenientBsnk"
-=-__..... 1-888-9;>/-U(;(;4
~ ~"""""II"C~.~$I:lI
~~it "171o,w ~L4;
(LW.L 'i ad..) {/
~ j J:>r~~,r
BalanCE> lolO/rflallOn rell&C1;, tl""rl~lIom. Illro"g~l ;';,00 PM on milt Ol,.i~nc.!;!: clay. :>ome 06POSI~ may nO! be il\lnnnOIO lur lmmeoliue l'I/illlClfOlW.u Cntlr.;l\~
!l:nr:l otMr items are reOllived lor deposit subject to the proVISIons of !he UniflJ{m Comrl\Etfde.l Code Of My applicable co\\ecl.ion agreement
:.:: :~ 'jfi:::~ ,_(., '.'J _
:,jbl_ .::::,j;..;
cr',"
8A-17.H8 (4103)
I ERIE
INSURANCE
E'XCHANGE
Member' Ene (nsurance Group
SUE.
ERIE INSURANCE EXCHANGE
P.O. BOX 1699 ERIE, PA 16530
NAMED INSURED COPY
C~NCELLATIONNOTtCE
CANCELLATION EFFECTIVE
07/30/03 12.01 AM
MAIL DATE
BAL:
08/01/03
$10.00 CR
POLICY NUMBER Q56 0903104 H
POLICY EFFECTIVE DATE 08/09/02
HOMEPROTECTOR POLICY
STANDARD TIME
NAMED INSURED
1...111...111....1.1,.1.1,..1,11
THE ESTATE OF MARIE E SHULTZ
802 APPLE DR AA7605
MECHANICSBURG PA 17055
WE ARE NOTIFYING YOU THAT THE ABOVE POLICY IS CANCELLED AS OF THE CANCELLATION
EFFECTIVE HOUR AND DATE SHOWN ABOVE. IF WE HAVE BEEN ASKED TO PROTECT OTHER
INTERESTS, WE ARE REQUIRED TO ADVISE THEM OF THIS CANCELLATION.
THE REASON FOR THIS ACTION :
REQUEST OF NAMED INSURED - SOLD
PREVIOUS BALANCE
UNUSED PREMIUM
PRESENT BALANCE
$.00
$10.00 CR
$10.00 CR
00521
p-to.,ftcl
~e'd Cf:..
f/rs/a3
g::- /1r/o J
AA7605
FARN FARNHAM INSURANCE AGY
932EXC 6/00
BRICKERS AUCnoN
Buy & Sellon 'Commission- CompleteSaleSe1'Vice
93 Texaco Rd., Mechanicsburg, PA 17055 766-5785
Sold At Public Sale
2063
Personal Property of
Address
,.-
dNi
Outstanding
Total Sale
Total Checks
Total Cash
Cash After Payout
Expenses
Auctioneer & Clerks
Adv. Cost
Property Fee
Sale Setup or Help J- SU, cl
Total Expenses I 3'6 . 6V
fJ~ be FJJ
{$
Thank You For Selecting Chuck Bricker, Auctioneer & Staff
M\JMM~S
'We.wett.S' Jto't...
o '" 34 WEST MAIN STREET
MECHANICSBURG, PA 17055
APPRAISAL
Phone: 766-9422
J!; - }..~ ~ ),..D il;' APPRAISAL
Appraisal For:
1
/VV\- RJ E.
,I=. f~
1=-6,
{;,
s Hu fj--z-
~oJ tY..Jdace.
1'1 I' 1
CtJ
LA-J; "-"
...-It." -4-
IU e~ (Q,cl hat'
C hcu N.
J '-/d j..Le. ,
C vi t' ~ O/'L,'~ fer+--. <k
~)
I~t
ht\,t' Il.I
tJ:s- Il'lIYt F~
0'1
6--v<l
Kcutlb rQO--t1
~P~" t 7J; ti. Tv\~
~
ct'j
?C-l.l
~
t::C<A..
t..A- d.: G.o
rJh !<-Lv.
{]Vt4,
~'r
s- /l.\M r~ a..J If" 1
p~ <4R-1/~ crk~
J A l.LlC'
...
4~~o- '"
J k 5' 1..0, cP
G~ /Z'^t'
uj_ It... t r..1k F
I'-/- t4 Jl/~a ~tZ C~l~-
V (}..( IJ.{ SO, d
$"'1'1"1-
r I f' ,/'" 00
V CA.i J ~ ~~
"
This appraisal constitutes our carefully studied opinion of
o t~ retail replacement cost through our facilities
!!t'1F1e distress soles nature value
of the ortic\e{s) ~cribed above insofar as the mounting(sl have permitted
observation. e assume no liability with respect to any action that may be
taken on the osis 0 this appraisal.
'EV.''''''X.''.'''.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DE EDENT
EST ATE OF S I-J
U. L TZj
SCHEDULEF
JOINTLY -OWNED PROPERTY
F. /h/f,(!.IE
FILE NUMBER
.2./-o;l. - lIS'
If an asset was made joint within one year of the decedent's date of death, n must be reported on SChedule G.
A. J.lf.I?~V e. SH U L rz.
SURVIVING JOINT TENANT(S) NAME
~oN
ADDRESS
RELATIONSHIP TO DECEDENT
80.2 /toPPlE "DiI-1II IF.
mEi(!/iANlcsauaG, 1'/1 17 OS~
B. "TJofit>1HY A. HILDeB~Ili'J1:>
c. LONNIE SH tAL T'Z
:D. LA-!>ENe ~Ye<.s
I::! <;. 'TbIJE Hl!illb R.'I>.
-:D1Lt.SBUl';!G-, PA liol"1
D thl.. Hra<'
110\ N.W '3t>ji, Ct.
wi"".., lYIa""rs J FL 333/1
iD eo...r\ SJ::.
t3..ilil1.<1 .spY"i,,~,,". PA 1'007
So",
";bAu GHT"fS'R.
JOINTLY.OWNED PROPERTY:
LETTER DATE
ITEM FOR JOINT MADE
NUMBER TENANT JOINT
1. A. ,.2r;.~
'B. "
c. "
:D. "
DESCRIPTION OF PROPERTY
Include name of finarlCial institution &Ad bank account number or similw identifying number. Attach DATE OF DEATH
deed for joinUy-held real estate. VALUE OF ASSET
~O;l1t +ent:t."2f w;H. ri.}Jt of S",..viv.1"Sh.f ~I:J..(P, 000.00
,"te.~{.t l"-\...Il --rhaf Qerf,,;n iPr"l"u~
IOc....teol o.t 802 IIpple P6ve ;., HtL
"Bbro"jl, of lY\ec.ha.nicsbu'J J C....,.loerl...
Cb"'1' (JennsyrV/1tJ;" "".s mo:par-
-f,'~t-<lt:\r Iy desc...; bed ',., -tCt..k cr:rT&t.n ~'"
lZ'. mt:t...ie: Sh...\t.z: -/>> r::. Ma....e Sh...tfzj
\..atry E Sh"ltz, Lonnie E. Sh...It"7, o.nJ
"Dorb+i1y Jl-. 1.../..ldehrA..J _ti La- Dene
/l1. fi\yers J reCDrde./ ~ D~d -:&'"k IZS;
pat 7;/,0. (&ee ~J a.th..c-heJ)
#pprli"sd 6)' /J1tfrK E. fI//krt FAssDCS.
tis hIlY"~1 a d./?e/. ndue tI ~.z6,a:>~.'"
(See cJf1y Cl--ltacJd)
%OF
DECO'S
INTEREST
DATE OF DEATH
VALUE OF
DECEDENT'S INTEREST
f& :J.S,,2[)O. DO
,;w1o
* .:r"fo Note: fu;d pn>l'vr\ iJ.'Ob sold
+0 u..~"Y €. Sl"u.1tz ::"y otkr ha......t...
.j;".. &<I..c:1 lifPro.i501 p..ic... ..... Slo,,~ 1I..zo~
TOTAL (Also enteron line 6, Recapitulation) $ as, ';;00.00
(if more space is needed, insert additional sheets of the same size)
Mark E. Hilbert & Associates
03-172M1
File No 03-172M1
********* INVOICE *********
File Number: 03-172M1
Summay Appraisal Report
Charles Shields Esq.
6 Clouser Road
Mechanicsburg, PA 17055
Borrower:
Elizabeth Shults Estate
Invoice # :
Order Date :
Reference/C ase # :
PO Number:
03-172M1
March 6, 2003
03-172M1
802 Apple Drive
Mechanicsburg, PA 17055
$ 300.00
$
Invoice Total
State Sales Tax @
Deposit
Deposit
$
$
($
($
- - ~ - . - - - - - - - - -
$ PAID
300.00
0.00
300.00 )
)
Amount Due
Terms: Balance due upon receipt of invoice: 15% fee if paid 30 days past receipt
Please Make Check Payable To:
MARK E. HILBERT & ASSOCIATES
14 North Walnut Street
Mechanicsburg, PA 17055
Fed. 1.0, #: 23-2391423
TO INSURE PROPER CREDIT
PLEASE RETURN A COpy OF THIS INVOICE WITH YOUR PAYMENT.
14 North Walnut Street, Mechanicsburg, PA 17055 717-7664988/717-795-9301 Fax
Mark E. Hilbert & Associates
03-172M1
File No. 03-172M1
SUMMARY APPRAISAL OF REAL ESTATE
Summery Appraisal
LOCATED AT:
802 Apple Drive
Mechanicsburg, PA 17055
FOR:
Charles Shields Esq.
6 Clouser Road
Mechanicsburg, PA. 17055
BORROWER:
Elizabeth Shults Estate
AS OF:
DATE OF DEATH DECEMBER 17, 2002
BY:
Mark E. Hilbert
MARK E. HILBERT & ASSOCIATES
14 North Walnut Street, Mechanicsburg, PA 17055 717-7664988/717-795-9301 Fax
03-172M1
Prooertv Oewiolion UNIFORM RESIDENTIAL APPRAISAL REPORT File No. 03-172M1
Prooertv Add:ess 802' Aoole Drive Cilv Mechanicsbura Slate PA 210 Code 17055
L.,.I Descriollon Allached Counlv Cum berland
Assessor's Parcel No. Tax Year R.E. Taxes $ Snecial Assessments $ NIA
Borrower Elizabelh Shults Estate Current OWner Estste Oceuoanl: I I Owner I I Tenant IXl Vacant
.. Prooertvriohtseooralsed ixl FeeSimole Il Leasehold I Proiecllvoe il PUD I I CondominiumtHUDNAonlv\ HOA$ NIA IMo.
Neiohbomood or Proiect Name Borauoh of Mechanicsbura Man Reterence Census Tracl 115
Sale Price $ Estate Date of Sale NI A Descriotion and $ amount of loan chameslconcess\ons to be oaid bv seDeI" NJ A
Lender/CHenl Charles Shields Eso. Address 6 Clouser Road Mechanicsburo PA. 17055
Aooralser Mark E. Hilbert Address 14 North Walnut Street Mechanicsbura. PA 17055
Location W Urban ~ Suburban 0 Rural Predominant Single family housing Present land use %
Built up 00 Over 75% 0 25~75% 0 Under 25% occupancy r~1E ~~f One family 76%
Growth rale 0 Rapid [R) Slable 0 Slow [R) Owner 95 Low 30 24 famHy 15%
Property values [R) Increasing 0 Stable 0 Dedlrung 0 Tenant ~295 Hioh 125 Mu~.faml~ 3%
Demandlsupply Q Shortage (Rllnbala1ca Q Ova-~ /xi Vacant(G5%) Predomlnanl -- ~ommer~ai 4%
Marketinatime I r Under 3 lIDS. lXI3-6mos. I lOver6mos n Vacant/over5%' 140 I s"'Q1..Vacant \ 2%
Note: Race and the racial composition of the neighborhood are not appraisal factors.
Neighborhood boundaries and characteristics: Pronertv is located at the corner of Annie and Allendale Drives in the develooment of Orchard
: Crest Borauah of Mechanicsbura. Cumberland Countv Pennsvlvania.
[!J Factors that affect the marketability of the properties in the neighborhood (proximity to employment and amenities, employment stability, appeal to market, etc.):
RLThe subiect prooertv has aood access to area emolovment and amenities.
Land use change
[R) Nol likely 0 Likely
o In process
To:
..
Market conditions in the subject neighborhood (including support for the above conclusions related to the trend of property values, demand/supply, and marketing time
. _ such as data on competitive properties for sale in the neighborhood, description of the prevalence of sales and financing concessions, etc.):
Financino is readilv available from a varietv of sources and with imnrovinn markets sellers are not reauired to offer sales or financina
related concessions.
. Project Information for PUDs (If applicable) ~. Is the developer/builder in control of the Home Owners' Association (HOA)? U YES lXJ NO
Approximate tatal number af units in the subject project N/A Approximate total number of units for sale in the subject project N/A
Describe common elements and recreational facilities: N/A
Dirrensions 125.6 x 83.17 x 125.03 x 80 Topography Level
Site area 10224 SQ.FI. +/- Corner Lot [KJ Ves U No Size 0.234 Acres
Specific zoning classification and description Residential Shape Rectanaular
Zoning oompHance [R) Legai J;J Legal nonoon~ng (Grandfatl,..ed use) [J lIIegai U No zoning Drainage Aooears adeouate
Hiohest & best use as improved: I X I Present use I I Other use fexolain\ View Residential
Utilities Public Other Off-site Improvements Type Public Private Landscaping Adeauate
Electricity [R) 200 AMP Street Macadam ; 0 Driveway Surface Concrete
Gas [R) Prooane Curblgutter Concrete X 0 Apparent easements Tvoical-Utilitv
Water [R) Sidewalk Concrete X 0 FEMA Special Flood Hazard Area U Yes [KJ No
Sanitary .ewer [Xl Street lights Y as ~ 0 FEMA Zone "C" Map Date 3-3-92
Storm sewer !Xl AII~ None I I M FEMA Mao No. 420362-0005-0
Comments (apparent adverse easements, encroachments, special assessments, slide areas, illegal or legal nonconforming zoning, use, etc.): There are no
aooarent adverse easements encroachments snecial assessments or zoninn that would have a neaatlve imoact on the value of the
subiect Prooertv. subiect however to reservations easements conditions and rlaht ot wa of record.
GENERAl DESCRIPTION EXTERIOR DESCRIPTiON FOUNDATION BASEMENT
No. of Unlls One Foundation Block Slab No Area SqH 1176
No. of Stories One Exterior Walls Brick O'aY.4Spare No % Finished 50%
Type (DeUAtt.) Detached Roof Surface Comnosition Basemenl Full Ceiling Ceilina Tile
Design (Style) Ranch Gutters & Ownspts. Aluminum sump Pump Floor Drain Walls Panel
EXistinglProposed Existlna 'Mndow Type ObI. Huno Dampness None noted Floor Carpet
Age (Vrs.) 50 +/- StormlScreens YES YES Settiement None noted OulsideEn1!y Yes
Effective Aoe IYrs.) 8-10 ManutacturedHouse No Infeslation None noted
. ROOMS FOller livirm Dinino Kitchen Den Familv Rm. Rec. Rm. Bedrooms
o Besemerl 1 1
Levell 1 Area 1 1 3
. Level 2
iNSULATION
Roof
Ceiling
Walls
Floor
None
Unknown
o
[R)
o
o
o
o
# Baths
XX
1
Laundrv
1
Other
Storaoe
Area SoH
1176
1512
.
. Finished area above nrade contains: 6 Rooms' 3 Bedroom s . 1 Bathls\: 1 512 Souare Feet of Gross Livinn Area
0 INTERIOR Materials/Condition HEATING KITCHEN EQUIP. ATTiC AMENiTIES CAR STORAGE:
Fioors Caroet I Avn Type Hot Air Refrigerator ~ None 8 F<epiace(s}#L- [R) None [R)
. Walls Drvwall / Avo Fuel Oil Range/Oven Stairs .." C~... ~ Garage # of cars
Trim/Finish Wood I Avo CoodiOOnAva. Disposei 2S Drop Stair 0 Deck Attached
Bath Floor CeramicTilell Avo COOLING Dishwasher 2S Scuttle 8 Porch Detached
Bath Wai!1Soot Ceramic Tile I Avo Central Cenll Air FanlHood 2S Floor Fence Built-In
Doors Hollow Core Other None Microwave 2S Heated Pool Carport
CoodilionAvn. WasherJDrver X Finished H Trash Compactor [xi Drivewav 2
Additional features (special energy efficient items, etc.): XX Lower level has Comode Shower but not in same location.
Condition of the improvements, depreciation (physical, functional, and external), repairs needed, Quality of construction remodeling/additions, etc.: No maior
reoairs noted. No evidence of funclional or external obsolescence.
.
Adverse environmental conditions (such as, but not limited to, hazardous wastes, toxic substances, etc.) present in the improvements, on the site, or in the
immediate vicinity of the subject property: There are no visible or aooarent adverse environmental conditions that would neaativelv imoact
the value of the subiect orooertv.
FraddJe Mac Form 70 6-93
PAGE 1 OF 2
ProdllCedu.lngPolaroldDlgitaISolulion..of\W&r"IDl.~34_a727__p<>larotdform'_coll1
FannieMaeFcwm1004 6-93
ESTIMATED SITE VALUE. . . . . . . . . . . . . . . . . . . . . . . . . . . " $
ES,IMA TED REPRODUCTION COST -NEW OF IMPROVEMENTS:
Dwelling 1,512 Sq.Ft. @$ 48.15 "$
_ Bsmt.1176 Sq.Ft. @$ 16.75"
. F/P Patio Trash Comoactor "
I GfrBgelCa'p:rt _ Sq. Ft. @ $ ::
- Total Estimated Cost New ................ = $ 96,501
. Less Physical.Oj Functional i External Est. Remaining Econ. Life:
Depredation $7478 I I = $ 7,478
Depreciated Value of Improvements . . . . . . . . . . . . . . . . . . ;: $ 89 023
"As_is" Value of Site Improvements................,.. :. $ 3500
INDICATED VALUE BY COST APPROACH. . . . . . . . . .. "$ 127500 Estimated Remainino Economic Life is 30-35 vears.
ITEM SUBJECT COMPARABLE NO.1 COMPARABLE NO.2 COMPARABLE NO.3
802 Apple Drive 906 Apple Drive 1112 Charles Street 302 Maple Street
Address~ Mchanicsbur PA Mechanicsbura. PA Mechanicsbura. PA Shiremanstown PA
Proximilv to Subiect . 1 Block 0.35 Miles 1.35 Miles
Sales Price $ 126000 $ 119900 $ 134900 $ 137900
PricelGrossLiv.Area $ 83.33 III $ 87.14 III $ 99.41 III $ 111.93 iZI
Data and/or Inspection C.P.M.L. C.P.M.L. C.P.M.L.
Verification Sources Countv Records Aaent Aaent Aaent
VALUEAOJUSWENTS OESCRIPTION DESCRIPTiON I .(-}$Adi"Im~! DESCRIPTION I .(-}$Ad..ImM! DESCRIPTION I '(-}$M""""!
Sales or Financing DOM 9 : DOM 30 : DOM 62
Concessions Conventional: Conventional: Conventional
Oateol SalelTirre 11-26-02: 12-16-02: 11-06-02
Location Suburban Suburban' Suburban' Suburban
Leasehd<lfeeSirde Fee Simole Fee Simole: Fee Simple: Fee Simple
Site 0.234 Acres 0.39 Acres: 0.257 Acres: 0.21 Acres
View Residential Residental' Residentai' Residental
Oeslon and Aooeal Ranch I Avo. Ranch I Ava.: Ranch I Ava.: Ranch I Ava.
<l1aIivofCalslrucli:xl Brick Brick I Alumin: Brick I Alumin: Brick
Aoe 50 Yrs. 50 +1- ' 39 ' 40 Yrs
Condition Averaae Averaoe : Above Averaae: -5 500 Above Averaoe :
Above Grade Total I &Irma' B.attw. latal I Mimi' Balhs : Tala! \ Bdrm~ \ Baths : Total' Blhns' Baths :
~ Room Count 6: 3: 1.00 6: 3: 1.00' 6: 3: 1/1' -2,000 6: 3: 1/1'
. GrossLivinoArea 1512Sn.Ft. 1376SoH.: +2000 1357SoH.: +2300 1232SoH.:
Baserrent & Fmlshed Full Full : Full : Full
. Rooms Below Grade Rec. Rm./Bed R Unfinished : +4000 Rec. Room ' +1 500 Rec. Room/Den
: Functional Utililv Averaoe Averaoe : Averaae : Averaae
. Hoatino/Coolinn Hot Air ClAir H.Pumo I CIA: Hat Air-ClAir: H.Water I ClAir
. Enerav Eflidentltems Averaae Averaae ' Averaoe ' Averaoe
Garaae/Caroort Off 51. Parkina 1 Car Garaae: -3 000 1 Caroort : -2 000 1 Caroort
. Parch, Patio, Deck, Patio Porchl Patio : -1,500 Patio : Porch
Fireolacers), etc. 2 Fireplaces 2 Fireolaces' None '+4 000 Fireolace
Fence, Pool, ele. Trash ComDactor None : +500 None : +500 Fence
None None : Sun Roam : -6 500 New Roof
Not Adi. (total) X T - '$ 2000ltiiiX - '$ 7700ltlilX - '$
A<justed Sales Plice
alComoarable $ 121 900 $ 127200 $
Comments on Sales Comparison (including the subject property's compatibility to the neighborhood, ete) See Attached.
35 000
03-172M1
File No. 03-172M1
Comments on Cost Approach (such as, source of cost estimate,
site value, square foot calculation and for HUD, VA and FmHA, the
estimated remaining economic life of the property):
In the reoroductlon cost of imarovements the Marshall &
Swift Residential Cast Handbook as well as local
contractors are referenced.
Valuation SlOction
UNIFORM RESIDENTIAL APPRAISAL REPORT
72,803
19,698
4,000
-5500
-2,000
+4 200
,
,
,
,
,
,
,
,
,
, -2000
,
, -1,500
,
, +2 000
,
: -1000
, -3000
,
8800
129100
ITEM SUBJECT COMPARABLE NO.1 COMPARABLE NO. 2 COMPARABt.E NO.3
Date, Price and Data None None None None
SoLfcefcrJXit:rsaes N/A NIA N/A N/A
tMthinvea-ofaoaraisaJ Owner's Deed C.P.M.L/Court Hause C.P.M.L/Court House C.P.M.L/Court House
Analysis of any current agreement of sale, option, or listing of the subject property and analysis of any IJbr sales of subject and c:ompocables within one yecr of the date of appraisal:
N/A
INDICATED VALUE BY SALES COMPARISON APPROACH . ................................... ............$ 126000
INDICATED VALUE BY INCOME APPROACH (II AooIicable\ Eslimated Market Rent $ NI A /Mo. x Gross Rert Mulliolier NI A "$ NI A
This appraisal is made .110 "as Is" 0 subjed ta the repa.., alterations, ~spocllons" oondtions listed bekJW U subject 10 oompIelian per plans and spociica\ions.
COn<itions al Apprajsal: The aooralser assumes a marketabie title and that eauipment associated with the imorovement is in workina order.
final Reconciliation: The market approach reinforced bv the cast approach is a aood indicator of fair market value. The fael that the seller
is or is not Davina anv portion of the ciosin!l costs has no effect on this aooraisal.
. DATE OF DEATH DECEMBER 17 2002
~ The purpose of this appraisal is to estimate the market value of the real property that is the subject of this report, based on the above conditions and the certification, contingent
and limiting conditions, and market value definition that ere stated in the attactJed Freddie Mac Fcrm 4391Fannie Mae Fcrm 10048 (Revised 6/93 ).
I {WE} ESTIMATE THE MARKET VALUE, AS DEFINED, OF THE REAL PROPERTY THAT IS THE SUBJECT OF THIS REPORT, AS OF Decem ber 17, 2002
. (WHICH IS TH~DATE OF IN ~N AN!l1:lolE EFFECTIVE DATE OFTHIS REPORT) TO BE $ 126,000 ,
. APPRAISER: , ~ff _ SUPERVISORY APPRAISER (ONLY IF REQUIRED):
SiQnature :..., : Signature (XJOid ODid Not
Name Mark!~ . e Z Name Inspect Property
Date Report Signed March 25, 2003 Date Reoort Sloned
Slate Certification # RL-000388-L State PA State Certification # State
Or State L1canse # RB-029755-A State PA Or State License # State
FreddieMecForm70 6-93
PAGE 2 OF 2
Pr<>dUcedUlingPolIroidOigllaISolutiOl1'lOlIwlll"o.aoo,234!l127www,poIil1'Oid1orm1,00l1I
FannieMaeForm1004 6.93
Mark E. Hilbert and Assoc.
ADDENDUM
Borrowe(; Elizabeth Shults Estate
Prqpertv Address: 802 Apple Drive
City: MechanicsburQ
Lender: Charles Shields Esq.
File No.: 03-172M1
Case No.: 03-172M1
State: PA Zip: 17055
Comments on Sales Comparison
The property's heating, plumbing and electrical systems appear to be functioning properly to the best
of the appraiser's knowledge and expertise.
I am unable to verify the insulation "R" factor. The presence of UREA-FORMALDEHYDE FOAM
INSULATION could not be determined. If UFFI is present, the appraised market value may be
adversely affected or voided. Any information about insulation stated on the appraisal was provided
by inspection, owner or agent and is assumed to be accurate.
The appraiser in not aware of the existence of Radon Gas and/or Radon Daughters and does not
have the necessary equipment to test for presence of same. If a future test shows unacceptable
levels of Radon present, the appraised market value may be adversely effected or voided.
Please be advised that in the market data analysis grid, bathrooms are adjusted for on the first line
and gross living area/room count are adjusted together as a single adjustment on the second line.
The subject is over 30 years old, but has been modernized as necessary and is marketable in its
present condition. The effective age is significantly less than 30 years.
It is noted that the price per sq. ft. of gross living area for comparable sale No(s) 2-3 varies by more
that $10.00 per sq. ft. compared to the subject. The comparables chosen are the best available.
Addendum Page 1 of 1
SUBJECT PROPERTY PHOTO ADDENDUM
Borrower: Elizabeth Shults Estate FileNo.: 03-172M1
Property Address: 802 Apple Drive Case No.: 03-172M1
C~y: Mechanicsburg State: PA Zip: 17055
Lender: Charles Shields Esn.
FRONT VIEW OF
SUBJECT PROPERTY
Appraised Date: March 12, 2003
Appraised Value: $126,000
REAR VIEW OF
SUBJECT PROPERTY
STREET SCENE
COMPARABLE PROPERTY PHOTO ADDt:NUUM
BOITower: Elizabeth Shults Estate FileNo.: 03-172M1
Property Address: 802 Apple Drive Case No.: 03-172M1
CRY: Mechan'icsburg Slate: PA Zip: 17055
Lend"': Charles Shields Es".
COMPARABLE SALE #1
906 Apple Drive
Mechanicsburg, PA
Sale Date: 11-26-02
Sale Price: $ 119,900
COMPARABLE SALE #2
1112 Charles Street
Mechanicsburg, PA
Sale Date: 12-16-02
Sale Price: $ 134,900
COMPARABLE SALE #3
302 Maple Street
Shiremanstown, PA
Sale Date: 11-06-02
Sale Price: $ 137,900
Borr;.>wer/Client
, Property Address
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63/1E/28J3 05:56
7177957473
SHIELDS
P?~GE I~L?
,
) "70 'Sb Sh\Ql~
Tax Parcel No. I]-.U -oEI..3_.::Il?
Made the :2~ day Of14-
ninety-five (1995).
THIS nRRn
in the year one thousand nine hundred and
Between E. MARIE SHULTZ, single WOl11lUl, of the Borough
ofMechanicsburll, Cumbcdand CountY, Pmnsylvania, Grantor,
and
E. MARJE SHULTZ, LARRY E. SHULTZ, LONNIE E. SlIUL1Z,
DORomY A. HILDEBRAND, and LA-DENE M. MYERS, as joint
lCnants with right of survivorship and not as telWlts in common, of
Cumberland County, Pennsylvania, Grantees
THIS IS A TRANSACIlON BETWEEN PARENT TO (::HlLDREN AND
THEREFORE IS TRANSFER TAX EXEMPT.
WlTNESSETII, that in consideration of die sum of ONE ($1.00) DOLLAR in hand paid.
me receipt whereof is hereby acknowledged. the said c;Jrantm does hc:reby grant and convey to the
said Grantees, their hem and assigns:
AIL mAT CERTAIN piece IX parcellX land sit\lalC in the Borough of
Mechanicsburg, County of Cumherlalld, Swc of Pennsylvania, l11<lII'e
pII1ie~,\;1nn\lOP<j lI"<I described.u fallows:
BEOlNNING at a point in the center of the Allmdale Road (Township
Road No. 6(8) at the interseCtion of the southern line of Apple Drive as
shown on the hereinafter mcndOl1ed PlI1l\ of Lola; THENCE by the southern
line of Apple Drive, North 73 degrees 17 minutes East, OIIe hW1dred
twenty-five and six onc-bu~ (125.06) feet to a point, THENCE by
the dividing line between Lots No.1 and 2 on said Plan. South 16 degl'lle$
40 minutes 35 scconds Eut eiaJtty-three and seventy-one OIle htmdredths
(83.71) feet to a point; THENCE-by lands ofKendaIIParlette. South 74
degtees 59 minutes West one hundred twenty-five and three ooe-hundIMths
(125.03) feet moo: or less 10 a point In the center line of the aforesaid public
road; THENCE by the center line of said 1'l'l8d, North 16 degrees 43 minutes
West eighty (80) feet 10 a point, the Place of BEGrNNING.
BEINO pan of Lor No. } in the Plan of Lots of Orchant Crest, Section I-A
and }-e (n:viscd plan), whk:h plan is recorded in the CumberlllDd O>unty
Rocordcr's Office in Plan Book } 0, at Pace I.
lIA VINO THEREON ERBCl'ED PREMl'SES 802 APPLE DRIVE.
SUBJECT, NEVER11iELESS, 10 a ri&h~-of-way or ~nt 20 feet in
width extending from Applo Drive to IAnd.s of Parlene along the dividing
line between the property herein conveyed and Lot No.2 OIl said Plan for
the w.~!allation of a Sewer line, toghethcr with the nJb! of ingress, egress
and regress fot' inspection, RplIir or replal:ement of said sewer line.
BEING the pn:mi1iCS whicb Joseph E. Richards and Margaret Ann
Richards, his wife, by their deed dared May 22, 1974 and recorded in the
Recorder of Deeds Office in Cumberland County In Deed Book ~p".
Volume 23, Page 962, &J'lIIItcd and conveyed unto Irvin O. Ritter and E.
Marie Shultz. '!:hI: said Irvin O. Ritter depancd this earthly life on Februlll'y
14. 1990 whcn:upon full and absolute tide vesled in E. Marie Shultz by
"1."tuc of survivonbip ~cordinll to the law of Pel1llsylvania.
.BOOK 12.5 I'M;E '720
03/15/2803 05:56
7177357473
SHIELDS
Pt;l6E 02
-:
.
AND the sald Granlor win wamml generally the propeny hereby conveyed.
1N WITNESS WHEREOF. the said Grantor has hereunto set her hand and seal the day and
year fU'St above written.
Signed, sealed and delivered
ill the pIescnc:e of;
a~4t~
{~~s~;{L~:;'"
(SEAL)
COMMONWEALlH OF PBNNSYLV ANIA:
: 55.
COUNfY OF CUMBERLAND
On this. the .7S'" day of (LJ,L.. ,A.D. 1995. before me the
undersigned officer. personally ~ ~MARIB SHlJl:r.z. known to me. (or satisfactorily
proven) 10 ~ the person whose nllUle is subllCribed to the within insaumem:. and acknowledlled
that she e~uted the same: for the purpoaes 1:heRin lXHltained.
IN WITNESS WHEREOF. I hereunto set my hand and otf'lCiallie8.1
~.
NotarY Public
l~ml~' MIo
~BOIIl~~
MyComrr;sob,~.1lnlI2li, '1lI8
, -
I HEREBY CERTIFY that the precise rcsidenoe of the Grantee is ~ J..
~ &J~>_~I?1~ . PIf I1DJ"S'
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Anomey forGwuec
(M 7:'S')
St.11 of 'etlI~ \ IS '.
county of Ct/.,,~ tor \tMt ,........dinll
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"..:. !O,and fo(.!?,,~ ~ Plge.lCO . ~"'."
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MUL TI-PURPOSE SUPPLEMENTAL ADDENDUM
FOR FEDERALLY RELATED TRANSACTIONS (FIRREA)
03-172M1
03-172M1
Borrower/Client Elizabeth Shults Estate
Properly Address 802 Apple Drive
City Mechanicsburg County Cumberland
Lender Charles Shields ESQ.
This Multi-Purpose Supplemental Addendum for Federally Related Transactions was designed to provide the appraiser with a con-
venient way to comply with the current appraisal standards and requirements of the Federal Deposit Insurance Corporation (FDIC),
the Office of the Comptroller of Currency (OCC), The Office of Thrift Supervision (OTS), the Resoiution Trust Corporation (RTC)
and the Federal Reserve.
Slale P A
Zip Code 17055
Th1s Multl~Purpose Supplemental Addendum Is for use with any appraisal. Only those
statements which have been checked by the appraiser apply to the property being appralsed.
EI PURPOSE & FUNCTION OF APPRAISAL
The purpose of the appraisal is to estimate the market value of the subject property as defined herein. The function of the appraisal is
to assist the above-named Lender in evaluating the subject property for lending purposes. This is a federally related transacHon.
EI EXTENT OF APPRAISAL PROCESS
00 The appraisal is based on the information gathered by the appraiser from public records, other identified sources, inspection of the
subject property and neighborhood, and selection of comparable sales within the subject market area. The original source of the com-
parables is shown in the Data Source section of the market grid along with the source of confirmation, if available. The original source
is presented first. The sources and data are considered reliable. When conlllcting information was provided, the source deemed most
reliable has been used. Data believed to be unreliable was not included in the report nor used as a basis for the value conclusion.
W The Reproduction Cost is based on Marshall & Swift Residential Cost Handbook/Local Contractors.
supplemented by the appraiser's knowledge of the local market.
[]] Physical.depre~iation is based o~ the estimated effective age of the subject pr~pertr Functi.onal and/or externa.l depreciat!on, if
present, IS specifically addressed In the appraisal report or other addenda. In estlmatlng the sIte value, the appraIser has relied on
personal knowledge of the local market. This knowledge is based on prior and/or current analysis of site sales and/or abstraction of site
values from sales of improved properties.
W The subject property is located in an area of primarily owner-occupied single family residenGes and the Income Approach is not consi-
dered to be meaningful. For this reason, the Income Approach was not used.
o The Estimated Market Rent and Gross Rent Multiplier utilized in the Income Approach are based on the appraiser's knowledge of the
subject market area. The rental knowledge is based on prior andlor current rental rate surveys of residential properties. The Gross Rent
Multiplier is based on prior and/or current analysis of prices and market rates for residential properties.
D For income producing properties, actual rents, vacancies and expenses hava been reported and analyzed. They have been used to pro~
ject future rents, vacancies and expenses.
EI SUBJECT PROPERTY OFFERING INFORMATION
According to Owner the subject property;
X has not been offered for sale in the past _ months or L- years.
is currently offered for sale for $
was offered for sale within the past _ months or _ years.
Offering information WClS considered in the final reconciliation of value.
Offering information WiIS not considered in the final reconciliation of value.
Offering information was not available. The reasons for unavailability and the steps taken by the appraiser are explainecllater in
this addendum.
EI SALES HISTORY OF SUBJECT PROPERTY
According to Deed
B has not transferred in the past - months or L- years.
has transferred in the past _ months or _ years.
All prior sales which have occurred in the past _ months or _ years are listed below and reconciled to the
a raised value, either in the bod of the re art or in the addenda.
Date Sales Price Document.". Seller Buyer
the subject property;
EI FEMA FLOOD HAZARD DATA
W Subject property Is not located In a FEMA Special Flood Hazard Area.
D Sub'ect ro e Is located in a FEMA S eelal Flood Hazard Area.
Zone FEMA Ma IPanel#
Ma Date
Name of Communlt
"e"
420362-0005-0
3-3-92
Borough of Mechanlcsburg
The community does not participate in the National Flood Insurance Program.
X The community does participate in the National Flood Insurance Program.
It is covered by a regular program.
It is covered b an emer ency TO ram.
FW.10M Forma & Worm. Inc., 315 Whitney Ave, New Haven, CT 06511 All Rights Reserved
D&eembel"19n ThltlormreproducedYJjlhp&rrrU..ionon lheAClDevelopm....lRapldForm.ayst"",(BOO}234-<l721
03-172M1
03-172M1
EI CURRENT SALES CONTRACT
WThe subject property is currently not under contract.
DThe contract and/or escrow instructions were not available for review. The unavailability of the contract is explained later in the
addenda section.
DThe contract andlor escrow instructions were reviewed. The following summarizes the contract:
Contract Date Amendment Date Contract Price Seller
DThe contract indicated that personal property was not Included in the sale.
DThe contract indicated that personal property was included. It consisted of
Estimated contributory value is $
DPersonal property was not included in the final value estimate.
DPersonal property was Included in the final value estimate.
Drhe contract indicated no financing concessions or other incentives,
DThe contract indicated the following concessions or incentives:
DJf concessions or incentives exist, the comparables were checked for similar concessions and appropriate adjustments were made, if
applicable, so tha11he final value conclusion is In compliance with the Market Value defined herein,
EI MARKET OVERVIEW Include an explanatIOn of current market conditIOns and trends
Six months is considered a reasonable marketing period for the subject property based on multi-listing service data.
EI ADDITIONAL CERTIFICATION
(1)
The Appraiser certifies and agrees that
Their analyses, opinions and conclusions were developed, and this report was prepared, in conformity with the Uniform Standards of
Professional Appraisal Practice ("US PAP"), and in accordance with the regulations developed by the Lender's Federal Regulatory
Agency as required by FIRREA, except that the Departure Provisions of the USPAP do not apply,
Their compensation is not contingent upon the reporting of predetermined value or direction in value that favors the cause of the
client, the amount of the value estimate, the attainment of a stipulated result, or the occurrence of a subsequent event.
This appraisal assignment was not based on the requested minimum valuation, a specific valuation, or the approval of a loan.
(2)
(3)
EI ADDITIONAL (ENVIRONMENTAL) LIMITING CONDITIONS
The value estimated is based on the assumption that the property is not negatively affected by the existence of hazardous substances or
detrimental environmental conditions unless otherwise stated in this report. The appraiser is not an expert In the identification of
hazardous substances or detrimental environmental conditions, The appraiser's routine Jnspection of and inquiries about the subject
property did not develop any information that Indicated any apparent significant hazardous substances or detrimental environmental
conditions which would affect the property negatively unless otherwise stated in this report. It is possible that tests and inspections made
by a qualified hazardous substance and environmental expert would reveal the existence of hazardous substances or detrimental
environmental conditions on or around the property that would negatively affect Its value,
. ADDITIONAL COMMENTS
Appraiser's Signature
Appraiser's Name {prin
State PA
March 12. 2003
Phone # ( 717 ) 766-4988
Certification # RL-000388-L Tax ID # 23-2391423
. CO-SIGNING APPRAISER'S CERTIFICATION
DThe co-signing appraiser has personally Inspected the subject property, both inside and out, and has made an exterior inspection of all
comparable sales listed in the report. The report was prepared by the appraiser under direct supervision of the co.signing appraiser.
The co-signing appraiser accepts responSibility for the contents of the report including the value conclusions and the limiting condi-
tions, and confirms ~hat the certifications apply furly to the co-signing appraiser
DThe co.signing appraiser has not personally inspected the interior of the subject property and:
aha. not inspected the exterior of the subject property and all comparable sales listed in the report.
has Inspected the exterior of the subject property and all comparable sales listed in the report.
The report was prepared by the appraiser under direct supervision of the co.signlng appraiser. The co.signing appraiser accepts
responsibility for the contents of 1he report, including the value conclusions and the limiting conditions, and confirms that the
certifications apply fully to the co-signing appraiser with the exception of the certification regarding physical inspections, The above
describes a level of inspection performed by the co-signing appraiser.
DThe co-signing appraiser's level of inspection, involvement in the appraisal process and certification are covered elsewheTe in the
addenda section of this appraisal.
EI CO-SIGNING APPRAISER'S SIGNATURE & LICENSE/CERTIFICATION
Appraiser's Signature DTralnee
Appraiser's Name (prJnt)
State DLicense D Certified Residential D CertificatJon #
D Review
SS #
OOther
FW-70M
Decerroer1992
Forma &WOl'mslnc., 315 Whitney Ave. New Havan, CT 06511 All Rights Reserved
This fQ"m reprodtlCfld with pefmlssiOll 0111118 ACI D8Yf1lopmoot RilpidForm~ ~ystem (800) 234..5721
Borrower EtizabeUI Shulls Estate FileNo. 03-172M1
Pron;;;;Address 802 Annie Drive
Cilv' Mechanicsburn County Cumberland Stete PA ZiD Code 17055
Lender Charles Shields Esn.
APPRAISAL AND REPORT IDENTIFICATION
This appraisal conforms to ~ of the following definitions:
00 Complete Appraisal
o Limited Appraisal
(The act or process of estimating value, or an opinion of value, performed without invoking the Departure Rule.)
(The act or process of estimating value, or an opinion of value, performed under and resulting from invoking the
Departure Rule.)
This report is ~ of the following types:
o Self Contained
00 Summary
o Restricted
(A written report prepared under Standards Rule 2-2(a) of a Complete or Limited Appraisal performed under 5T ANDARD 1.)
(A written report prepared under Standards Rule 2-2(b) of a Complete or Limited Appraisal performed under 5T ANDARD 1.)
(A written report prepared under Standards Rule 2-2(c) of a Complete or limited Appraisal performed under STANDARD 1
for client use only.)
Comments on Standards Rule 2.3
I certify that, to the best of my knowledge and belief;
. The statements of fact contained in this report are true and correct.
. The reported analyses, opinions, and conclusions are limited only by the reported assumptions and limiting conditions, and are my personal, impartial, and unbiased
professional analyses, opinions and conclusions.
. I have no present or prospective interest in the property that is the subject of this report, and no personal interest with respect to the parties involved.
. I have no bias with respect to the property that is the subject of this report or the parties involved with this assignment.
. My engagement in this assignment was not contingent upon developing or reporting predetermined results.
. My compensation for completing this assignment is not contingent upon the development or reporting of a predetermined value or direction in value that favors the
cause of the client, the amount of the value opinion, the attainment of a stipulated result, or the occurrence of a subsequent event directly related to the intended
use of this appraisal.
. My analyses, opinions and conclusions were developed and this report has been prepared, in conformity with the Uniform Standards of Professional Appraisal
Practice.
. 100 have 0 have not made a personal inspection of the property that is the subject of this report.
Comments on Appraisal and Report Identification
Note any departures from Standards Rules 1-2, 1-3, 1-4, plus any USPAP-related issues requiring disciosure:
:~:'::ISER:.~#
Name: Mark t". i ert
Date Signed: March 25, 2003
Stat. Certification #: RL-000388-L
or Stete License #: RB-029755-A
State: PA
Expwation Oat. of Certification or License: 6-30-2003
SUPERVISORY APPRAISER (only if required):
Signature:
Name:
Date Signed:
State Certification #:
a State License #:
State: PA
Expiration Date of Certification a License:
1Rl Did
o Did Not Inspect Property
USPAP Iden~fiCil~on (Rev 9199)
10f1
ProW""dus;ngPolaroid~9~"'Solulianssoflwalll.800,234_a127y<ww,pol"'oldla-ml,com
03-172M1
File No. 03-172M1
DEFINITION OF MARKET VALUE: The most probable price which a property should bring in a competitive and open market
under ali conditions requisite to a fair sale, the buyer and selier, each acting prudently, knowiedgeably and assuming the price is not
affected by undue stimulus. Implicit In this definition is the consummation of a sale as of a specified date and the passing of tille from
selier to buyer under conditions whereby: (1) buyer and selier are typicaliy motivated; (2) both parties are well informed or well advised,
and each acting in what he considers his own best interest; (3) a reasonable time Is allowed for exposure in the open market; (4) payment
is made in terms of cash in U.S. dollars or in terms of financial arrangements comparable thereto; and (5) the price represents the normal
consideration for the property sold unaffected by special or creative financing or sales concessions' granted by anyone associated with the
sale.
'Adjustments to the comparables must be made for special or creative financing or sales concessions. No adjustments are necessary for
those costs which are normally paid by sellers as a result of tradition or law in a market area; theSe costs are readily identifiable since the
selier pays theSe costs In virtualiy all sales transactions. Special or creative financing adjustments can be made to the comparable property
by comparisons to financing terms offered by a third party institutional lender that is not already involVed In the property or transaction. Any
adjustment should not be calculated on a mechanical doliar for doliar cost of the financing or concession but the dollar amount of any
adjustment should approximate the markers reaction to the financing or concessions based on the Appraiser's judgment.
STATEMENT OF LIMITING CONDITIONS AND APPRAISER'S CERTIFICATION
CONTINGENT AND LIMITING CONDITIONS: The appraiser's certification that appears in the appraisai report is subject to the
following conditions:
1. The appraiser wili not be responsible for matters of a legal nature that affect either the property being appraised or the title to it. The
appraiser assumes that the tille is good and marketable and, therefore, wili not render any opinions about the tille. The property is appraised
on the basis of it being under responsible ownership.
2. The appraiser has provided a sketch in the appraisai report to show approximate dimensions of the improvements and the sketch is
included only to assist the reader of the report in visualizing the property and understanding the appraiser's determination of its size.
3. The appraiser has examined the available flood maps that are provided by the Federal Emergency Management Agency (or other data
sources) and has noted in the appraisal report whether the subject site is located in an identified Special Flood Hazard Area. Because the
appraiser is not a surveyor, he or she makes no guarantees, express or implied, regarding this determination.
4. The appraiser wili not give testimony or appear in court because he or she made an appraisai of the property in question, unless specific
arrangements to do so have been made beforehand.
5. The appraiser has estimated the valUe of the land in the cost approach at its highest and best use and the improvements at their
contributory vaiue. These separate valuations of the land and ImprOVements must not be used in conjunction with any other appraisal and
are invalid if they are so used.
6. The appraiser has noted in the appraisal report any adverSe conditions (such as, needed repairs, depreciation, the presence of hazardous
wastes, toxic substances, etc. ) observed during the inspection of the subject property or that he or she became aware of during the normai
research invoived in performing the appraisal. Uniess otherwiSe stated in the appraisal report, the appraiser has no knowledge of any hidden
or unapparent conditions of the property or adverse environmental conditions (inciuding the preSenCe of hazardous wastes, toxic
substances, etc. ) that would make the property more or less valuable, and has assumed that there are no such conditions and makes no
guarantees or warranties, express or implied, regarding the condition of the property. The appraiSer will not be responsible for any such
conditions that do exist or for any engineering or testing that might be required to discover whether such conditions exist. Because the
appraiSer is not an expert in the fieid of environmentai hazards, the appralsai report must not be considered as an environmental assessment
of the property.
7. The appraiser obtained the information, estimateS, and opinions that were expressed in the appraisai report from sources that he or she
considers to be reliable and believes them to be true and correct. The appraiser does not assume responsibility for the accuracy of such
items that were furnished by other parties.
8. The appraiSer will not disclose the contents of the appraisal report except as prOVided for in the Uniform Standards of Professional
Appraisal Practice.
9. The appraiser has based his or her appraisal report and valuation conciusion for an appraisal that is subject to satisfactory compietion,
repairs, or alterations on the assumption that completion of the improvements will be performed in a workmanlike manner.
10. The appraiser must provide his or her prior written consent before the lender/client specified in the appraisal report can distribute the
appraisal report (including conclusions about the property valUe, the appraiSer's identity and professional designations, and references to
any professional appraisal organizations or the firm with which the appraiser is associated) to anyone other than the borrOWer; the
mortgagee or its successors and assigns; the mortgage insurer; consultants; professional appraisai organizations; any state or federally
approved financial institution; or any department, agency, or instrumentality of the United States or any state or the District of Columbia;
except that the lenderlclient may distribute the property description section of the report oniy to data collection or reporting service(s)
without having to obtain the appraiser's prior written consent. The appraiser's written consent and approval must also be obtained before
the appraisal can be conveyed by anyone to the public through advertising, public relations, news, saies, or other media.
Freddie Mac Form 439 6-93
Page f of 2
Fannie Mae Form 1004B 6-93
03-172M1
File No. 03-172M 1
APPRAISERS CERTIFICATION: The Appraiser certifies and agrees that:
1. I have researched the subject market area and have selected a minimum of three recent sales of properties most similar and proximate
to the subject property for consideration In the sales comparison analysis and have made a dollar adjustment when appropriate to reflect the
market reaction to those items of signmcant variation. If a signmcant Item in a comparable property is superior to , or more favorabie than,
the subject property, I have made a negative adjustment to reduce the adjusted saies price of the comparable and, if a significant item in a
comparable property is inferior to, or less favorable than the subject property, I have made a positive adjustment to increase the adjusted
saies price of the comparable.
2. i have taken into consideration the factors that have an impact on value in my development of the estimate of market value in the
appraisal report. I have not knowingly withheld any significant Information from the appraisal report and I believe, to the best of my
knowledge, that all statements and infOfmation in the appraisal repOft are true and correct.
3. I stated in the appraisal report only my own personal, unbiased, and professional analysis, opinions, and conclusions, which are subject
oniy to the contingent and limiting conditions specified in this fOfm.
4. I have no present or prospective interest in the property that is the subject to this report, and I have no present or prospective personal
interest or bias with respect to the participants in the transaction. I did not base, either partially or completely, my analysis and/or the
estimate of market value in the appraisal report on the race, coior, religion, sex, handicap, familial status, or national origin of either the
prospective owners or occupants of the subject property or of the present owners or occupants of the properties in the vicinity of the
subject property.
5. I have no present or contemplated future interest in the subject property, and neither my current or future employment nor my
compensation for perfO(ming this appraisal is contingent on the appraised value of the property.
6. i was not required to report a predetermined value or direction in value that favors the cause of the client or any related party,
the amount of the value estimate, the attainment of a specific result, or the occurrence of a subsequent event in order to receive my
compensation and/or employment for performing the appraisal. I did not base the appraisal report on a requested minimum valuation, a
specific valuation, or the need to approve a specific mortgage loan.
7. I performed this appraisal in conformity with the Uniform Standards of Professional Appraisal Practice that were adopted and
promulgated by the Appraisal Standards Board of The Appraisal Foundation and that were In place as of the effective date of this appraisal,
with the exception of the departure provision of those Standards, which does not apply. I acknowledge that an estimate of a reasonable
time for exposure in the open market is a condition in the definition of market value and the estimate I developed is consistent with the
marketing time noted in the neighbochood section of this report, unless I have otherwise stated in the reconciliation section.
8. i have personally Inspected the interior and exterior areas of the subject property and the exterior of all properties listed as comparables
in the appraisal report. i further certify that i have noted any apparent or known adverse conditions in the subject improvements, on the
SUbject site, or on any site within the immediate vicinity of the subject property of which I am aware and have made adjustments for these
adverse conditions in my analysis of the property value to the extent that I had market evidence to support them. I have also commented
about the effect of the adverse conditions on the marketability of the subject property.
9. I personally prepared all conclusions and opinions about the reai estate that were set forth in the appraisal report. ill relied on
significant professionai assistance from any individual or individuals in the performance of the appraisal or the preparation of the appraisal
report, I have named such individual(s) and disclosed the specific tasks performed by them in the reconciliation section of this appraisal
report. I certify that any individual so named is qualified to perform the tasks. I have not authorized anyone to make a change to any item in
the report; Iherefore, if an unauthorized change is made to the appraisal repO(t, I will take no responsibility for it.
SUPERVISORY APPRAISER'S CERTIFICATION: il a supervisory appraiser signed the appraisal report, he or she certifies
and agrees that: I directly supervise the appraiser who prepared the appraisal report, have reviewed the appraisai report, agree with the
statements and conclusions of the appraiser, agree to be bound by the appraiser's certiftcations numbered 4 through 7 above, and am taking
full responsibility fO( the appraisal and lhe appraisal report.
ADDRESS OF PROPERTY APPRAISED: 802 Apple Drive, MechenicsburQ, PA 17055
APPRAISER:
Signature: ~
Name: Me . Hilbert
Date Signed: March 25, 2003
State Certification #: RL -00038B-L
or State License #: RB-029755-A
State: P A
Expiration Date of Certification 0( License: 6-30-2003
SUPERVISORY APPRAISER (only if required)
Signature:
Name:
Date Signed:
State Certification #:
or State License #:
State:
Expiration Date of Certification or License:
[XJ Old 0 Did Not Inspect Property
MARK E. HILBERT & ASSOCIATES
Freddie Mac Form 439 6-93
Page 2 of 2
Fannie Mae FOfm 1004B 6-93
'. CONFIRMATION OF COVERAGE
This binder Is a temporary Insurance contract, subject to
the conditions and exclusions of the Issuing policy.
\ .
NAME AND ADDRESS OF AlJENGY BINDER No.
202254
USI Colburn Insurance ServlcB COMPANY
One International Plaza CNA
Sulte-400
Philadelphia PA 19113
EFFECTIVE
May 1, 2002 12:01 a.m.
w_. . .
. W:t:"..::.~
EXPIRES
May 1, 200312:01 a.m.
NAME AND MAILING ADDRESS OF INSURED ATTACHMENTS TO ISSUING POlIcY
Mark E. Hilbert & Associates.
14 North Walnut Street
Mechanlcsburg, PA 17055
TYPE OP COVERAgE
Realtors Errors & OmIssIons Insurance
UMITS OF LIABilITY
$500,000 Each Claim I $500,000 Annual Aggregate
DEDUCTlin..G
$2500
\jAfJ~f'
April 1)3. 2002
DATE
81GNATURE OF AUTHORIZED REPREl?ENTATIVE
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"
QUALIFICATIONS Of APPRAISER
Mark E. Hilbert. CRIVIA. ICA. GAl
Bl'Okar Appraiser .
.
Eduoatlon:
RR.1 KRtatR PRuURylvauia TitlR InRurRuae, Harri'burg
Raal IRtata Theory and Praatioa
RRRl lIRhtR Law
Real I!lstata HlIth
RRa1 8state Appraisal I
neal BRtate AdvanoRd Appraieal
Standard. of Profe~.ional PraotloB - PKrt A
Standards of Profsdmional Prautio9 - Pa~h D
Market Extrsotiono
)'smti. MR,R JtnJ.C!I\f flll!Il1\iuB.r
,.........
--,
Professional Membershlpa and,Otltllgnat!ona:
SRnior Member - Intsxnotional'Orgsni.stion of nRsl KRtats Apprsi.ers
AmsrioBU rraternity of neal IRtats Apprai.er.
Graduats RRal KRt.tR Inetitute
Candidste Apprsi.Rl InRtitute
Hard.burg Boerd of nnItOrR
PllnneylvRnie /loud of Realtor.
penngylvanim A..ooiat!on of Realtors
NationlJll As.oal.tien of Real torR .
PIlnnRy1vsnis Stete CRrtifiaation Numbsr - RL-000388L
Expsrlenos:
C.M. DatwRiler ReRl IRtatR Ino.
Maroh 1971 to April 1P76
Stuard Derriok ReRl KRtetR Ino.
April 1976 to oOrobRr 1981
RR/MAX Resl~ A..ooiste.
Ootober 1981 to 'sbrus.y IPQ6
.
Mark B. Hilbart c. A..on:!.a\::el!l
'ebrus:ry 1986
ReBI Estate lIoenoe: March 1971
Assoolate BroIler: April 1976
AppraIsIng .slnce 1979.
AppralsBI Experlenlle:
IIpprsis.1~ for. Hrat mortgaQ'R. ..ooni! mortQ'RQ'R,
tranRfsro/reloostionR, ainQ'le family, oondo.
Cuntb.rJ.and, Y'O~kJ lJlluphln IUII:l I'et"ty Counti....
sqnity 10snR, BI11ploye"
Completed Anslgnmel1tu for:
BIlnJtIl, 9avingll anti. Loans, Morl:gaQ'l!! Brok'OJ:D
lJepat'tment.& Ilnd A\:.\:o:rneys.. ' Rtllooation Companies, Trogh
Client ~i.t aYRil~lG'upon reques~,
~, - ,..-....
ReV'''''',''''7I.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SfJULTZ EL/Z,f-&E7lI
,
SCHEDULE G
INTER.VIVOS TRANSFERS &
Mlse.NON.PROBATE PROPERTY
/IJ,
FILE NUMBER
.2./- () 2 - II sfo
ITEM
NUMBER
1.
This schedule must be completed and flied jf tile answer to any of Questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY
mCLUDETHE NAME OF THE TRANSFEREE, THEIR REi.ATlQNSHIPTO OECEDfNT AND THE DATE OF'TRANSFER
"'TT.".Crl" COP1 OFll-lE DEED fOR REAl ESTATE.
LII-ETt/J1E' ClIlFCkS T)~II-^,II PN :r,.,YES-r-
h1EN"f s4-VI/VGS AMT. '17 "11 -t>S J.r
/J7i:/H6eJ1(..$ P//i'sT - SH~IV# /I.r /"n:m 2.. E.
p/l St!#FDPt.E IE:
/!/J.v A-S' ITe/JJs /1 7'1,fPtlif/f 21 MI StYlE/>-
ut.E :z:.
~
c. 6-. ~ .f::;V.OO CH€~ n €/ft:lf ac
~UPW/N6- :
,1, L/I-,RlfY~, SHut. TZ
8, LR/'/.I/IIG SHut TZ
C 7::; t!>R 0 p,ly Hlt/>E6A!/1A'.o
7), LA-MAlE /l1Yl!i7fS
%OF
DATE OF DEATH DECD'S EXCLUSI~~ TAXABLE VALUE
VALUF OF ASSET INTER"ST IFAPPlICABl.E
~ , r" z SO, 0<
'/-, .frtfl. pP IDPl.:> 3,pco.Dd
X t.j. )< l.}. '1.q
-I
/7, ~()(). DO
~
/~a>O
..
s; pop. t?D
JOOt,
TOTAL (Also enter on line 7, Recapitulation) $..s-; RPP. ,po
(~more space is needed, insert additional sheets of the same size)
REV-1S<1 EX+ (12-99) ,
-
COMMONWEALTH OF' PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SatEDUW iM
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
SHU.L TZ,
€LIZ'HaE7Jf 1J1.
FILE NUMBER
ZI-OZ -IISk>
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A FUNERAL EXPENSES:
1. ~~bS.3. 71:>
/IIEI" FuI/lERIft. Nt/hlG", a,,#IfJ HIt.(. ,PA
:to 1111 CIf II /1(,. SEIF,(IE"P , PAS"??Nf1S ,f{pII/PN.If-;e,VA? ,.
I DD.OO
3, flElf(I!JUr<.Sf/IJGN1" 7P LIMfl Y SHUL:(Z R>~ 5uRCHIIRGl! M itllfl/NCG I' 3.,s0
7iJ (JAY j::JltfERAt ,BIll,
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions f
Name of Personal Representatlve(s) SE/1 SIi/JI9Ii!/f n;: SHeer ...f77-fC'HI!ID 3,S7S.0lJ
Social Security Number(s)/EIN Number of Personal Aepresentatlve{s)
Street Address
City Slate _ Zip
Year(s) Commission Paid:
C! H 11/U-es E. SHI t:t:.DS 7iI '/'
2. Attorney Fees 'I, J 5'/.S"/J
3. Family Exemption: (Ii decedent's address 15 not the same as claimant's, attach explanation)
LAlfliY e. ~
Claimant SHilL rz. ~ $l)/). 0()
Street Address 1?t>2 A-IJPi.E .Plelllt:
Grty /JJE CJ{IfJl/IC.s~vlt r;. State ,II?,If Zip /7PSS;
Relationship 01 Claimant to Decedent sPA'
4, Probate Fees ,;uu/ or!,,,,.t e"rfrhCares , (U''!(n,,/ ;5Sl)". ~ 7s:. "0
5. Accountant's Fees ~ WIiI-rCom6 7,NX ~ FIIf),NAlCII'f(" SERIIICIJ'S ~ ;-lo/ $". IfO
Tax Return Preparer's Fees ;:Dte CLoSfi OU, P~I?SOI\JII-L JNC/)iflE fAXa
6.
7. A-OVh21"1SII/G SIfU~ I:>F c.+,te _"oI'l7Je/t>T-;f/EIl/S ~";U.../O
'. /MYE/l'nSpvG S~C IF 0JS'Jt - 7J(G &uIDE ~ 7. z.o
9. f/lnS A-il7lJ/1Il>-n liE A!EPAI,(1- /N6P. { RG'P/lIR IN PI'i!EP FiPR ,
5.+,(7 pp: eM< :;l. 'Is-of{
/IJ. PI9 Y IJ/E/ff Or e;;AfHfIS.5IPA/S, G;yPEff.s~ E7?!., 7:Ji C!HilC'ft:
BRICKE7<. A-uc 77plI" /:l9(' (ut: s,71r7t4lENr ~T sc"vt:i). e:) ~
. I, 3Ro. 00
TOTAL (Also enler on line 9, Recapitulation) $ .:l:z, rtJ~. s-t
{ll more space is needed, insert additjonal sheets of the same size)
If.
js.
/6"
/7.
It':
1'1.
SC,HED. #., ~Alr'JJ.
EST. OF SIiJlI. 72., EZ/Z;fi!JE7?/ /II.
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I
117f7.SP
~~ ~,n IJ<',ep Tl(kA._ _/!,IL./Jji!/:5.f'A--A/./)
I" S?;AlE#~.o /CLJ.
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i ~C. SEC. IYp. j?/(-/(f' - ?9f3
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/
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!'.;)S'/ooo. D? _ CV 77., ~ f 7S"P. 00
~/o..o."o 0 tl.. = ~ :00. "0 .~
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= ~ 3U..o (aljufJ fi, ~1-1 va&.
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REV.1512EX"t(i.9?':*.,.
. ~ .'" ','
, ~,'
~
COMMONWEALTH OF PENNSYLVANIA
INH~~;;~~~ioTE'tE:~~RN MORTGAGE LIABILITIES, & LIENS
ESTATE OF
SHlIL7C:, ED?ASEm /Jf..
SCHEDULE I
DEBTS OF DECEDENT,
FILE NUMBER
;;l/-C,;z -lISt:,
Include unreimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION
1.
AMOUNT
oZ.
3.
'f.
s:
/'.
7.
0:
Itl-
/2..
I~.
1'1.
Is:
16.
1'7.
tlGt<IZM'
)/PUA/6"S /J1;:l>IC/H. =/fUIPr. tv'EsT
SEA'J"/CE O/~ {'o.
JfJrL ELEC. tI/iUrtES
CG"#77tA"/....N /3-i#,e- GeE'brr C/heb
l3o~/JIIGH cY= /PE&,I4#/CS.t3ttIPG, .:sEj(/Ei{?/~/(
fi1E//II,t3<<~E$4'7Yr 7Z> :Z;>o,e",lWV h'/L..tJE,sRA/II.1> mR
(}>.573" a,c ~P.lfltf' or: m4#re7 CLPCk - SE:NT OtIT
,t:i>/< ,.fE"PJ'9/A" ,s y l>EC!etJeVr
~E//IIdlftf'SE/'IIE7VT n ,Do,e'pfiY'Y H/C.tJE8R,tiM/b J:i>R. tM-?t!1if?
tSltt...
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fjdt./6$ P,(2)r'//A'E ~
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..tU'/>'/( IF /lll/eJtelM - O/<$I>!T c,p.~
,.
075.IZ
,.
7. 21/
~
<>2 ~-3:.3~
"/o~_ ! /
"
/"0. bD
~
5.3.l/2
~
/6>6.00
~
L/3. 00
,t
..:?S:/I
~ /0. 18"
lZ'
I~.llt
~/./6
"-9'2.'7
,
I, 970. 97
? '-. 170..3S"
'1.3.13
-'
.:;. 0 J o. '-17
,
.r b 'I b. I'
"
I. ;Z 3 g. 0.3
If.
CEIYTUI't/;,/I elM'./.' CRe-bIT M-/(R
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SE/-tJI=F.J A-GA/I/I.sT mEll/tBB{'S' F/~S T /fee- T.
t4,) j/ISA- (!REiN! 8M./>
.d.) It/llst;CIIREI) UlAN
c.J U4lsEC IA RIED ibM
(SEG Sl!#~j). iF. LEi77~"7( I::;ien~ 4IE/JUJE~J' ,cdlS.r)
TOTAL (Also enter on line 10, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
$ :z., is 'f. .2,
"
Sew!;.D. :I,
E:S7. of
1:(!: L/,c€7/IIfE
#c /9. "
jt Zo. II
oj( 21 ..
,
Co/IIT]J.
"SHULTZ
-,
EL /Z /.JIM 1H /11.
C!//EeK 70
J.A/lll)' E.
ShULTZ. {//.TB(CLe~~-:b.
/
" " LONNIe- SHuL TZ" " "
p " l)"'MTJIV HILOE8RJI/./ltD "
"
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SHUt.. -rz ~L/ZA6€ T"Y
,
SCHEDULE J
BENEFICIARIES
/71.
NUMBER
I.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS (include outrighl spousal distributions)
1.
121//# STi:t.rz€;f
;;S GJIlE'E7V8A!/A'A! LN" Z>/USBt/NG-, ,RA /7P/'1
I'<J'_ #/t.I>i:.s~A'A'P
/4 SPA'EN-.P -0., p/u&au;/!(;, ""';I /701'1
:;..
d'. .flWH lh?Al5
'# 1>PRPTNY /Y/aJB5RHIftL>
/2 SnM'GA'E71b If!,j)., :b/U-$BVR6, PA /7/>/9
~ LAR,ey i!i;. SNUl.TZ
8Dz ~Pt.G J>;2//,'t:, $ctW-?A'/C'S .BuA!?6 ,JH
/7pS$'
.5: ~771Y A. HId>E8/MN.l>
/:< GPA'ENtF""l> ;eo., )>/US.811N6,,oA 17"/9
b. L.MIN/IF -SHUL r.z
IltJl tV. Ut. .3f/fA CatIl7; uJ/L77W' ~II:S', ~L
3~~/f
7. L.,;f -t:1l!'7VE P1)'~
6 EA'.eL $7., ,($oIUAf6 SMIA/6s,;U,f /7"'07
FILE NUMBER
RELATIONSHIP TO DECEDENT
Do Not List Trustee{s)
G'l/'MI i)(!}f ILl>
GIt-WV/;>CHI<.l>
~}fl'-L>
S".iV
D,<f"'Gltr~
SON
XVfa6H TG"i!
2/_ 02 -(IS~
AMOUNT OR SHARE
OF ESTATE
f'
/,.~.()O
'/,bt'JO.CC
".
~ b6e> . DC>
Y<I
Y<f
Ylf
Y<,t
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II. ENTER TOTAL NON.TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $
(If more space Is needed, insert additional sheets of the same size)
LAST WILL AND TESTAMENT OF E. MARIE SHULTZ
21-2002-1156
I, E. MARIE SHULTZ, of the Borough of Mechanicsburg, Cumberland County,
Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and
declare this my Last Will and Testament, hereby revoking and making void any and all prior Wills
by me at any time heretofore made.
1.
I direct the payment of all my just debts and funeral expenses as soon after my decease as the
same can conveniently be done.
la.
I give and bequeath the sum of one thousand ($1,000.00) dollars to each of my grandchildren
listed in this paragraph as follows, to wit:
A.) Erin Seltzer;
B.) Ryan Hildebrand; and
C.) John Coons.
In the event any ofthem predecease me, his or her gift, as the case may be, shall lapse and
shall become part of the residue of my estate. Any inheritauce taxes due upon the above gifts shall
be paid from the residue of my estate.. ot ~ UtMd jht., ~ At (1 ~ d I7te ~
A<4 ~p~ #di of a;:J/JdmT ~ 4m/ ~ ,I. H.'/~eu JlUM~ ctI
1/7' 2. ~~~~
I am possessed of a lot of ground in Huntingdon County, Pennsylvania, situate betwe~ E2f<( 1
Robertsdale and Huntingdon. Should my son, LARRY E. SHULTZ, survive me, then I grant him the
option to purchase this lot from my estate at a price of Five Thousand ($5,000.00) Dollars. I
understand that the fair market value of the lot may be in excess of this figure and that its fair
market value will be the amount used to assess iuheritance taxes against my estate. My said son shall
have ninety (90) days to make up his mind and complete the purchase of the lot from my estate. In
the event my said son predeceases me or decides not to exercise this option, the option shall lapse
and the property free and clear of such option shall be considered part of the residue of mv estate.
3.
All the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and
wheresoever situate, I give, devise and bequeath in equal shares to my beloved children, per stirpes:
LARRY E. SHULTZ, LONNIE E. SHULTZ, DOROTHY A. HILDEBRAND, and LAD ENE M.
MYERS.
t, 111~ ~
L-1
4.
.
I nominate, constitnte and appoint my son, LARRY E. SHUL TZ, and my daughter,
.
DOROTHY A. HILDEBRAND, to be the Co-Executors of this, my Last Will and Testament. I
further direct that they shall not be required to file bond or other security in the Office of the
Register of Wills for the purpose of administering my Estate.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
)~ day of
.
~MAAa~ ,AD.
2002.
&, 1J1~':' ~
E. MARIE SHULTZ
(SEAL)
Signed, sealed, published and declared by the above-named E. MARIE SHULTZ, as and for
her Last Will and Testament, in the presence of us, who at her request and in her presence, and in
the presence of each other, have hereunto subscribed our names as witnesses.
{~A/ ~~z:::s-
~cfel(~
2
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1 7 1 2 8-0 601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 003188
SHIELDS CHARLES E III
6 CLOUSER ROAD
MECHANICSBURG, PA 17055
told
ESTATE INFORMATION: ssN: 27 i-z4-9686
FILE NUMBER: 2102-1 156
DECEDENT NAME: SHULTZ E MARIE
DATE OF PAYMENT: 1 0/31 /2003
POSTMARK DATE: 10/30/2003
COUNTY: CUMBERLAND
DATE OF DEATH: 1 2/ 1 7/2002
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
101 ~ S 1,437.56
REV-1162 EX(11-96)
TOTAL AMOUNT PAID:
REMARKS: CHARLES E SHIELDS III ESQUIRE
SEAL
INITIALS:
RECEIVED BY:
REGISTER OF WILLS
S 1,437.56
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17126-0601
CHARLES E SHIELDS III
6 CLOUSER RD
MECHANICSBURG PA 17055
REV-1547 IX RFP (01-03)
DATE 12-22-2003
ESTATE OF SHULTZ ELIZABETH M
DATE OF DEATH 12-17-2002
FILE NUMBER 21 02-1156
- COUNTY CUMBERLAND
ACN 101
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ------- RETAIN LOWER PORTION FOR YOUR RECORDS ~
------------------- -------------------------------------------------------------------------------
REV-1547 EX AFP CO1-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF SHULTZ ELIZABETH M FILE N0. 21 02-1156 ACN 101 DATE 12-22-2003
TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED
KtJtKYAI1UN CU!NCERNIN6 FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1) .00 NOTE: To insure proper
2. Stocks and Bonds (Schedule B) (2) 12 , 109.50 credit to your account,
3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 submit the upper portion
4. Mortgages/Notes Receivable (Schedule D) (4) .00 of this form with your
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 42, 29 7.13 tax payment.
6. Jointly Owned Property (Schedule F) (6) 25, 20 0.00
7. Transfers (Schedule G) (7)_ 5, 000.00
e. Total Assets (g) 84,606.63
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 22,8 06.56
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10)_ 29.8 54.26
11. Total Deductions C11) S?.660.8?
12. Net Value of Tax Return (12) 31,945.81
13. Charitable/Governmental Bequests; Non-elected 9113 Trus ts (Schedule J) C13) .00
14. Net Value of Estate Subject to Tax (14) 31,945.81
NOTE: If an assesseent was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate C15) .0 0 X 00 __ .00
16. Amount of Line 14 taxable at Lineal/Class A rate C16) 31 , 945.81 X 045 _ 1 , 437.56
17. Amount of Line 14 at Sibling rate (17) .00 X 12 _ .00
18. Amount of Line 14 taxable at Collateral/Class B rate (18) .00 X 15 _ .00
19. Principal Tax Due
T~V f•~e-TTTn - (lg)= 1,437.56
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
10-30-2003 CD003188 .00 1,437.56
BALANCE OF UNPAID INTEREST/PENALTY AS OF 10-31-2003 TOTAL TAX CREDIT 1,437.56
BALANCE OF TAX DUE .00
INTEREST AND PEN. g,47
TOTAL DUE 8.47
~ IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN 81, NO PAYMENT IS REQUIRED.
FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
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COMMONWEALTH OF PENNSYLVANIA
BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION
DEPT. 280601 NOTICE OF INHERITANCE TAX
HARRISBURG. PA 17126-0601
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
' OF DEDUCTIONS AND ASSESSMENT OF TAX REY-1547 IX ~FP (01 -03)
DATE 12-22-2003
` ESTATE OF SHULTZ ELIZABETH M
DATE OF DEATH 12-17-2002
FILE NUMBER 21 02-1156
_ COUNTY CUMBERLAND
CHARLES E SHIELDS III ACN 101
6 CLOUSER RD Amount Remitted
MECHANICSBURG PA 17055 ~ ~. y7
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~ _____________________
-----------------------------------
------------------------------- ------------------------
REV-1547 EX AFP CO1-03~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF SHULTZ ELIZABETH M FILE N0. 21 02-1156 ACN 101 DATE 12-22-2003
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
(1) .00 NOTE: To insure proper
1. Real Estate (Schedule A) 50
109
12 credit to your account,
2. Stocks and Bonds (Schedule B) (2) .
,
00 submit the upper portion
3 Closely Held Stock/Partnership Interest (Schedule C) (3) .
. (4) .00 of this form with your
4. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) C5) 42,297.13 tax payment.
6. Jointly Owned Property (Schedule F) (6) 25,200.00
(7) 5.000.00
7. Transfers (Schedule G) 84,606.63
- 8. Total Assets ($)
APPROVED DEDUCTIONS AND EXEMPTIONS: 22,806.56
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9)
_
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 29.8 54.26
82
~"
(11) i2.660.
11. Total Deductions 31,945.81
12. Net Value of Tax Return (1z) .00
13. Charitable/Governmental Bequests; Non-elected 9113 Trus ts (Schedu le J) (13) 31,94 5.81
14. Net Value of Estate Subject to Tax (14)
PiOTE: If an assessment was issuEd previously, lines 14, 15 ar,d/o: 15, 17, 18 and 19 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
00
00 .00
15. Amount of Line 14 at Spousal rate (15) .
81
945
31 X =
045 =
1 , 437.56
16. Amount of Line 14 taxable at Lineal/Class A rate (16) .
, X 00
17. Amount of Line 14 at Sibling rate
cln
.00
X
12
.
00
.18. Amount of Line 14 taxable at Collateral/Class B rate C18)
.00
X
15
.
1,437.56
19. Principal Tax Due
(19)=
TAX GREUIIS•
PAYMENT
RECEIPT
DISCOUNT (+)
AMOUNT PAID
y DATE NUMBER INTEREST/PEN PAID (-)
10-30-2003 CD003188 .00 1,437.56
BALANCE OF UNPAID INTEREST/PENALTY as ur
^ IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
10-31-2003 TOTAL TAX CREDIT 1,437.56
BALANCE OF TAX DUE .00
INTEREST AND PEN. 8.47
TOTAL DUE 8.47
( IF TOTAL DUE IS LESS THAN 81, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
RESERVATION: Estates of decedents dying on or before December 12, 1982 -- if aryy future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class B (collateral) rate on any such future interest.
PURPOSE OF
NOTICE: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000. (72 P.S.
Section 9140).
PAYMENT: Detach the top portion of this Notice and submit with your payment to the Register of Wills printed on the reverse side.
--Make check or money order payable to: REGISTER OF RILLS, AGENT
REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" CREY-1313). Applications are available at the Office
of the Register of Wills, any of the 23 Revenue District Offices, or by calling the special 24-hour
answering service for forms ordering: 1-800-362-2050; services for taxpayers with special hearing and / or
speaking needs: 1-800-447-3020 (TT only).
OBJECTIONS: Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment
of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
ADMIN-
ISTRATIVE
CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1501) for an explanation of administratively correctable errors.
DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (5Y
) discount of
the tax paid is allowed. ,
PENALTY: The 15% tax amnesty non-participation penalty is computed on the total of the tax and interest assessed
and not
paid before January 16, 1996, the first day after the end of the tax amnesty ,
period. This non-participation
penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
INTEREST: Interest is charged beginning with first day of delinquency, or n ine (9) nont hs and one (1) day fro
th
d
t
death, to the date of payment. Taxes which became delinquent before January m
e
a
e of
1, 1982 bear interest at the rate of
six (6Y.) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after
January 1, 1962 will bear interest at a rate which will vary from calendar ye ar to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2003 are
Interest Daily Interest
Daily :
Interest Daily
Year Rate Factor Y~ar Rate Factor Year Rate Factor
1982 20% .000548 1987 9% .000247 1999 7%
000192
1963 16% .000438 1988-1991 11Y. .000301 .
2000 8%
000219
1984 11% .000301 1992 9Y.
1995 .000247 .
2001 9Y. .000247
13% .000356 1993-1994 7% .000192 2002 6%
000164
1986 10% .000274 1995-1998 9% .000247 .
2003 5% .000137
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days
beyond the date of the assessment. If payment is made after the interest computation date shown on the
Notice, additional interest must be calculated.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1 7 1 28-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
SHIELDS CHARLES E III
6 CLOUSER ROAD
MECHANICSBURG, PA 17055
fold
ESTATE INFORMATION: ssrv: 21 i-24-9sss
FILE NUMBER: 2102-1 156
DECEDENT NAME: SHULTZ E MARIE
DATE OF PAYMENT: 1 2/30/2003
POSTMARK DATE: 1 2/23/2003
couNTY: CUMBERLAND
DATE OF DEATH: 1 2/ 1 7/2002
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 ~ 58.47
TOTAL AMOUNT PAID:
REMARKS: CHARLES E SHIELDS ESQUIRE
SEAL
CHECK#1147
58.47
DEPUTY REGISTER OF WILLS
INITIALS: VZ
RECEIVED BY: DONNA M. OTTO
REV-1162 EX111-96)
N0. CD 003385
REGISTER OF WILLS
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
Date of Death:
12-17-
Will No.
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
State whether administration of the estate is complete:
Yes ~< No__
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
3. If the answer to No. 1 is Yes, state the following:
a. Did the personal representative file a final
account with the Court? Yes__ No ~ .
b. The separate Orphans' Court No. (if any) for
the personal representative's account is:
c. Did the personal representative state an
account informally to the parties in interest? Yes_~ No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to this report.
Date:
Name (Please type or print
Address/Fec , s ,
Tel . No.
(MAH:rmf/AM3)
Capacity:
~Personal Representative
YCounsel for personal
representative
COMMONWEALTH OF PENNSYLVANIA
BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION
DEPT. 280601 INHERITANCE TAX
HARRISBURG, PA 17128-06D1
STATEMENT OF ACCOUNT
REV-1607 EX AFP (O1-OS7
zpATE 02-17-2004
;;;ESTATE OF SHULTZ ELIZABETH M
DATE OF DEATH 12-17-2002
FILE NUMBER 21 02-1156
~~~ ~~~~ 27 ~ ~ ~$~NNTY lO1BERLAND
CHARLES E SHIELDS III
6 CLOUSER RD Amount Remitted
MECHANICSBURG PA 17054- - _.u, t --
:'
~td~~ -..~~., Pfd
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment.
CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~
----------------------------------------------------------------------------------------------------------------
REV-1607 EX AFP (01-03) *** INHERITANCE TAX STATEMENT OF ACCOUNT *~~(
ESTATE OF SHULTZ ELIZABETH M FILE N0. 21 02-1156 ACN 101 DATE 02-17-2004
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 12-22-2003
PRINCIPAL TAX DUE:
PAYMENTS (TAX CREDITS):
1,437.56
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT (+)
INTEREST/PEN PAID (-) AMOUNT PAID
10-30-2003 CD003188 .00 1,437.56
12-23-2003 CD003385 8.47- 8.47
* IF PAID AFTER THIS DATE, SEE REVERSE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
TOTAL TAX CREDIT 1,437.56
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
( IF TOTAL DUE IS LESS THAN S1,
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR),
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
PAYMENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address
printed on the reverse side.
-- If RESIDENT DECEDENT make check or money order payable to: REGISTER OF WILLS, AGENT.
-- If NON-RESIDENT DECEDENT make check or money order payable to: COMMONWEALTH OF PENNSYLVANIA.
REFUND (CRI: A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an
"Application for Refund of Pennsylvania Inheritance and Estate Tax^ (REV-1313). Applications are available at
the Dffice of the Register of Wills, any of the 23 Revenue District Offices or from the Department's 24-hour
answering service for forms ordering: 1-800-362-2050; services for taxpayers with special hearing and / or
speaking needs: 1-800-447-3020 (TT only).
REPLY T0: questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau
of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601, phone
(7177 787-65D5.
DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (5%) discount
of the tax paid is allowed.
PENALTY: The 15% tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnesty period.
INTEREST: Interest is charged beginning with first day of delinquency, or nine (97 months and one (1) day from the date of
death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of
six (6%) percent per annum calculated at a daily rata of .000164. All taxes which became delinquent on and after
January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2003 are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
1982 20% .000548 1987 9% .000247 1999 7% .D00192
1983 16% .000438 1988-1991 11% .000301 zoos 8% .000219
1984 11% .000301 1992 9% .000247 2001 9% .000247
1985 13% .OOD356 1993-1994 7% .000192 2002 6% .000164
1986 10% .000274 1995-1998 9% .000247 2003 5% .oDD137
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15] days
beyond the date of the assessment. If payment is made after the interest computation date shown on the
Notice, additional interest must be calculated.